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18 NYCRR 521-1.1 — Scope and Applicability (Compliance Programs)
New YorkregulationNew York State Office of the Medicaid Inspector General (OMIG)· effective 2022-12-28
What this rule requires your agency to do
- 1Any person subject to Public Health Law article 28 or 36 (including licensed home care services agencies and certified home health agencies), Mental Hygiene Law articles 16 and 31, any Medicaid managed care organization or managed long term care plan, or any other person for whom the Medicaid program is or is reasonably expected to be a substantial portion of their business operations is a "required provider" and shall be subject to and comply with the compliance program requirements of Subpart 521-1 (subd. b).(18 NYCRR 521-1.1 — Scope and Applicability (Compliance Programs))
Applies to: personal care
Defines the scope of the mandatory Medicaid compliance program requirement and identifies which persons are "required providers" subject to Subpart 521-1 — including any person subject to Public Health Law articles 28 or 36 (which covers home care agencies and CHHAs), Mental Hygiene Law articles 16 and 31, Medicaid managed care organizations, and any person for whom Medicaid is a substantial portion of business.
Regulatory information, not legal advice — always confirm against the cited official source. Verification reduces error; it does not certify compliance.