2006 New York Code - 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.