New York Laws
Title 11 - Medical Assistance for Needy Persons
368-C - Audit of State Rates of Payment to Providers of Health Care Services.

§ 368-c. Audit of state rates of payment to providers of health care
services. 1. The commissioner may conduct, or have conducted, an audit
of financial and statistical reports used for the purpose of
establishing rates of payment or fees made in accordance with the
medical assistance program.

2. The commissioner shall implement audit procedures and activities to
enable the identification of the appropriate rates of payment made
through the medical assistance program. Furthermore the commissioner
shall conduct an annual review of financial and statistical reports with
respect to residential health care facilities certified pursuant to
article twenty-eight of the public health law. Where such review
indicates substantial noncompliance, as defined in regulation by the
commissioner, with the requirements of the medical assistance program
the commissioner shall conduct or have conducted an on-site audit.
Provided further however, that at least once every four fiscal years an
on-site audit shall be conducted.

3. To allow for the recomputation of affected fees or rates of
payment, the commissioner shall, as appropriate, supply audit findings
to the governmental agency or corporation organized and operating in
accordance with article forty-three of the insurance law responsible for
the promulgation of fees or rates of reimbursement.

4. The commissioner shall enter into interagency agreements, subject
to the approval of the director of the budget, to delineate the
respective responsibilities of the department and other governmental
agencies with respect to this section.

5. The commissioner is authorized to promulgate regulations to
implement the provisions of this section.

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