§ 368-C — Audit of state rates of payment to providers of health care services

New York § 368-C

• Jurisdiction: New York
• Law SOS: Social Services
• Title 11: Medical Assistance For Needy Persons
• Art. 5: Assistance and Care

Text

§ 368-c. Audit of state rates of payment to providers of health care\nservices. 1. The commissioner may conduct, or have conducted, an audit\nof financial and statistical reports used for the purpose of\nestablishing rates of payment or fees made in accordance with the\nmedical assistance program.\n 2. The commissioner shall implement audit procedures and activities to\nenable the identification of the appropriate rates of payment made\nthrough the medical assistance program. Furthermore the commissioner\nshall conduct an annual review of financial and statistical reports with\nrespect to residential health care facilities certified pursuant to\narticle twenty-eight of the public health law. Where such review\nindicates substantial noncompliance, as defined in regulation by the\ncommissioner, with the requirements of the medical assistance program\nthe commissioner shall conduct or have conducted an on-site audit.\nProvided further however, that at least once every four fiscal years an\non-site audit shall be conducted.\n 3. To allow for the recomputation of affected fees or rates of\npayment, the commissioner shall, as appropriate, supply audit findings\nto the governmental agency or corporation organized and operating in\naccordance with article forty-three of the insurance law responsible for\nthe promulgation of fees or rates of reimbursement.\n 4. The commissioner shall enter into interagency agreements, subject\nto the approval of the director of the budget, to delineate the\nrespective responsibilities of the department and other governmental\nagencies with respect to this section.\n 5. The commissioner is authorized to promulgate regulations to\nimplement the provisions of this section.\n