Deficit Reduction Act of 2005 – Posted September 29, 2017
Under the Deficit Reduction Act of 2005, NYC Health + Hospitals is required to inform all NYC Health + Hospitals/OneCity Health (“OneCity Health”) Workforce Members and Business Partners about its internal policies covering fraud, waste and abuse; the Federal False Claims Act and any similar law under the State of New York that governs false claims and statements; and whistleblower protections under Federal and State laws.
In accordance with this requirement, this memorandum from Wayne A. McNulty, Senior Assistant Vice President & Chief Corporate Compliance Officer, Office of Corporate Compliance (“OCC”), provides an overview of these policies and laws, respectively.
Compliance Requirements – Last Updated May, 2017
Under New York State law and requirements of the Office of Medicaid Inspector General (OMIG), all OneCity Health partners need to provide certain members of their workforce (described below) with New York State Delivery System Reform Incentive Payment (DSRIP) compliance training.
About DSRIP Compliance Training
At the bottom of this page, please find the following materials for download that further detail DSRIP compliance:
- A memorandum prepared by the NYC Health + Hospitals/OneCity Health Office of Corporate Compliance (OCC) which details the requirement that partners provide their workforce members who are involved or associated with, or otherwise affected by, the DSRIP Program, with DSRIP compliance training. The memorandum includes a presentation to help OneCity Health partners meet the compliance request. Click “Download the Compliance Memorandum and Training Presentation” at the bottom of this page
- Attestation form to complete and submit. Click “Download the Attestation Form” at the bottom of this page
- A second memorandum prepared by the NYC Health + Hospitals/OneCity Health Office of Corporate Compliance with additional details about the attestation. Click “Download the Memorandum on the Attestation” at the bottom of this page
How to Meet this Requirement
To assist our partners, within the memorandum below (click “Download the Compliance Memorandum and Training Presentation” at the bottom of this page) is a presentation titled “Delivery System Reform Incentive Payment Program Compliance Training and Education.” The PowerPoint addresses the following:
- Why is the establishment of a compliance program beneficial?
- What are the legally required elements of a compliance program?
- With regard to the required compliance program elements, what are the special considerations for DSRIP compliance?
- What are the definitions of the terms Fraud, Waste & Abuse and corresponding examples of the same?
- What are some of the Federal laws covering Fraud, Waste and Abuse that OneCity Health partners should be familiar with?
- How can OneCity Health partners report a DSRIP-related compliance issue or concern?
Our partners are welcome to utilize this presentation to satisfy their DSRIP compliance training and education requirements. Specifically, they can:
- Use it to develop a presentation for in-person/live compliance and education training;
- Incorporate the content of the PowerPoint into their existing compliance training and education computerized modules (e.g., automated online training); or
- Simply distribute the PowerPoint to their workforce members involved with or otherwise affected by the DSRIP program.
How to Attest to Completion
We developed an attestation form (which is available to download at the bottom of this page) to ensure our partners meet the requirements of the compliance program. The form contains three parts:
1. Completion of DSRIP compliance training
2. An acknowledgment that our partners workforce members are familiar with and adhere to the NYC Health + Hospitals’ Principles of Professional Conduct (more details immediately below)
3. Proof of OMIG compliance certifications if our partners are required by law and/or OMIG policy to certify the same (more details immediately below)
Principles of Professional Conduct
The NYC Health + Hospitals Principles of Professional Conduct (“POPC”) is a guide that sets forth NYC Health + Hospitals’ compliance expectations, describes standards of professional conduct, as well as efforts to prevent fraud, waste, and abuse. The POPC is attachment B within the memorandum available for download below (click the link “Download the Memorandum on the Attestation” at the bottom of the page), and requires our partners to:
- Adopt the POPC or their own code of conduct that includes the POPC’s core objectives or substantially similar compliance goals;
- Not engage in unprofessional conduct (e.g., improperly using DSRIP funds; or hiring or contracting with persons or entities excluded from participating in Federal health care programs such as Medicare and Medicaid) as described in Section VI of the POPC; and
- Timely report to the OCC any violation (related to the partner’s participation in the DSRIP program and/or the use of DSRIP funds) of the POPC of which a partner becomes aware.
In the attestation, our partners are asked to confirm whether or not they have met the foregoing requirements of the POPC.
OMIG Compliance Certifications
The attestation asks a series of questions to determine whether a partner is required to submit to OMIG one or both of the following certifications, and if so, whether said partner has actually carried out this requirement.
- The New York Social Services Law § 363-d Certification; and
- The Deficit Reduction Act of 2005 Certification.
Remember, not all partners are required to complete these OMIG compliance certifications. Rather, only partners that meet certain criteria are required to annually file such certifications. The memorandum available for download (click the link “Download the Memorandum on the Attestation” at the bottom of the page) describes the criteria for both of the above-mentioned certifications.
Completion and Return of the Attestation
An authorized representative of each partner is required to complete, sign, and return the attestation form no later than May 31, 2017, by email, fax, or regular mail to:
NYC Health + Hospitals/OneCity Health
Senior Executive Compliance Officer
Office of Corporate Compliance
160 Water Street, Suite 1129
New York, New York 10038
Office number: (646) 458-5644
Fax number: (646) 458-5624
We recommend our partners consult with their legal counsel if they have questions.