New York Codes, Rules and Regulations
Title 18 - DEPARTMENT OF SOCIAL SERVICES
Chapter II - Regulations of the Department of Social Services
Subchapter E - Medical Care
Article 3 - Policies and Standards Governing Provision of Medical and Dental Care
Part 515 - Provider Sanctions
Section 515.10 - Reinstatement

Universal Citation: 18 NY Comp Codes Rules and Regs ยง 515.10

Current through Register Vol. 46, No. 39, September 25, 2024

(a) A person sanctioned under this Part may request reinstatement, or removal of any condition or limitation on participation in the medical assistance program, at any time after the date or time period specified in the notice of agency action, or upon the occurrence of an event specified in the notice.

(b) A request for reinstatement or for removal of any condition or limitation on participation in the program is made as an application for enrollment under Part 504 of this Title and must be denominated as a request for reinstatement to distinguish it from an original application.

(c) The request for reinstatement must be sent to the provider enrollment unit of the department.

(d) The request must:

(1) include a complete ownership and control disclosure statement;

(2) state whether the party has been convicted of other offenses related to participation in the Medicare, Medicaid or social services programs which were not considered during the development of the sanction; and

(3) state whether any State or local licensing authorities have taken any adverse action against the party for offenses related to participation in the Medicare, Medicaid or social services programs which were not considered during the development of the sanction.

(e) The department may grant reinstatement only if it is reasonably certain that the violation(s) that led to sanction will not be repeated.

(f) If the department approves the request for reinstatement, it must give written notice to the party, and to all others who were informed of the sanction, specifying the date on which program participation may resume.

(g) If the department does not approve the request for reinstatement, it will notify the party of its decision.

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