PPS Provider Appeals - DY1 Q3

• Appeal is also available in Portable Document Format (PDF, 54KB)

PPS Provider Name: Bassett Healthcare Network Appeal 1 of 1

Conclusion:
Provider unsuccessfully appealed the Independent Assessor´s findings relative to Financial Sustainability Milestone 3.

Independent Assessor initially failed the Bassett Healthcare Network PPS for Financial Sustainability Milestone 3 which required the PPS to submit a copy of the certification confirmation received from the New York State Office of Medicaid Inspector General (OMIG) indicating that its Compliance Program meets the requirements of the law and regulation. The PPS submitted its DSRIP Compliance Policy and subsequently, during remediation, the OMIG Compliance Program Certification application but failed to submit the OMIG Compliance Program certification confirmation.

Upon appeal, the PPS acknowledged that they submitted the OMIG certification application and admitted that it was not until after receiving the adjudicated report that they submitted the incorrect document. The PPS proceeded to submit the Compliance Program certification confirmation with its appeal. As the IA received the document for the first time during the appeal, the IA could not accept the document and had to uphold its initial determination.