December 2, 2014

This is the month practitioners who bill or order more than $500,000 or straight or HMO Medicaid money are required to certify their compliance program for the coming year.  In case you are not aware of the requirement, qualifying practitioners to the above monetary precipice are required to have a compliance program in place, and certify annually.  The compliance program is required to have certain elements included related to - 

1. billings;
2. payments;
3. medical necessity and quality of care;
4. governance;
5. mandatory reporting;
6. credentialing; and
7. other risk areas that are or should, with due diligence, be identified by the Medicaid provider.

For assistance with your compliance program, click here or contact Jennifer at 516 747 6700 x. 302, or Erica at 516 747 6700 x. 308,

To certify your plan or learn more about NYS' requirement - click here -

For prior newsletters on this topic, click here. 


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  Have a question or comment for Jennifer?
       Contact Jennifer at or  at (516) 747-6700 x. 302.