OMIG Issues Changes to December 2018 Certification

The New York State Office of the Medicaid Inspector General (OMIG) has issued updates to its certification process for applicable Medicaid and Managed Medicaid providers, which may have a significant impact on providers who are required to certify by December 31, 2018.

OMIG has expanded its certification to adopt five separate categories listed on the updated Social Services Law Certification Form: (i) Annual Certification, (ii) Enrolling Provider Certification, (iii) Revalidating Provider Certification, (iv) Certification After Correcting Insufficiencies Identified in a Compliance Program Review, and (v) Certification After Receiving Notice of Regulatory Action for Failing to Complete Your Annual Certification.

In addition to the Provider Name and Federal Employer Identification Number (FEIN), OMIG now requires the Provider ID and National Provider Identifier Number (NPI) to be included in the certification form. Multiple Provider ID’s may be submitted in one certification form if the following five conditions are met:

1. The same compliance program applies to all Provider IDs listed on the certification form,
2. The Certification Category chosen is the same for all Provider IDs,
3. The Compliance Officer is the same for all Provider IDs,
4. The Certifying Official is the same for all Provider IDs (the Certifying Official must be someone other than the Compliance Officer), and
5. All Provider IDs reported on the certification have the same FEIN.

When completing the OMIG Compliance Certification, providers are no longer required to click “yes” or “no” to evidence satisfaction of the eight elements of a compliance program (see “Deadline Approaches to Certify Compliance Programs”). Now, compliance with such elements are incorporated into the certification, which generally states that the provider meets all requirements of SSL § 363-d and Part 521 and that the provider’s compliance program will remain in place until the next December certification period.

OMIG recommends that Certifying Officials conduct a compliance self-assessment prior to submitting the certification. OMIG makes clear in its certification that “making a false statement in this certification may subject you to criminal prosecution for a misdemeanor or felony under the New York State Penal Law.”

OMIG has issued a webinar to assist providers in completing the certification process. Providers should maintain a copy of the Certification confirmation on record evidencing compliance with the December 31 deadline.