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18 NYCRR 521-1.5 — Compliance Program Reviews (OMIG)
New YorkregulationNew York State Office of the Medicaid Inspector General (OMIG)· effective 2022-12-28
What this rule requires your agency to do
- 1The required provider must maintain a compliance program that satisfies this SubPart, has been continuously implemented and operated for the entire period under review, and is effective, because OMIG may review at any time to confirm these facts and a program found not to satisfy Social Services Law 363-d and this SubPart may subject the provider to monetary penalties under Part 516 and revocation (termination) of Medicaid participation under Part 504 (subds. b, d).(18 NYCRR 521-1.5 — Compliance Program Reviews (OMIG))
- 2When notified of an OMIG compliance program review, the required provider shall provide its responses, including any requested records, in the form and manner prescribed by OMIG within thirty (30) days of the date on OMIG's notification of intent to commence the review (OMIG may extend this period for good cause shown) (subd. c).(18 NYCRR 521-1.5 — Compliance Program Reviews (OMIG))
Applies to: personal care
Authorizes OMIG to review a required provider's compliance program at any time, sets the provider's duty to respond with records within 30 days of notification, and describes OMIG's determination and the consequences (monetary penalties under Part 516 and possible Medicaid termination under Part 504) where the program is found deficient.
Regulatory information, not legal advice — always confirm against the cited official source. Verification reduces error; it does not certify compliance.