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 521 - Fraud, Waste and Abuse Prevention
Subpart 521-3 - SELF-DISCLOSURE PROGRAM
Section 521-3.5 - Returning the overpayment

Universal Citation: 18 NY Comp Codes Rules and Regs ยง 521-3.5

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

(a) Once OMIG has completed its review and verified the amount of the overpayment OMIG shall notify the person of the amount of the overpayment and interest if applicable, and such notification shall contain instructions for remitting payment to the department. Interest may be waived in the sole discretion of OMIG.

(1) The notification will be issued in accordance with the provisions of subdivision (a) of section 521-3.6 of this SubPart.

(2) The person shall remit the full amount of the overpayment and interest within fifteen (15) days of the date of OMIG's notification of the determination of the amount of the overpayment, and interest, unless the person has been approved by OMIG to repay the overpayment through installments.

(3) Where a person has been approved to repay the overpayment and interest through installment payments, OMIG's notification of the amount of the overpayment shall also include an SDCA which the person shall execute and return to OMIG within the timeframe specified in paragraph (3) of subdivision (e) of section 521-3.4 of this SubPart.
(i) In order to remain eligible to participate in OMIG's Self-Disclosure Program the person must comply with all the terms of the SDCA, including the schedule of repayments.

(4) Notwithstanding any provision tolling the deadline to report, return and explain, in no event shall the person be required to repay the full amount of the overpayment and interest prior to the expiration of the deadline to report, return and explain, as set forth in paragraph (1) of subdivision (b) of section 521-3.3 of this SubPart.

(b) The full amount of any overpayment shall become immediately due and payable, with interest, if:

(1) the person fails to remit payment, either for the full amount of the overpayment or any scheduled installment payment pursuant to the terms of an SDCA, or

(2) participation in the Self-Disclosure Program is terminated in accordance with the provisions of subdivision (f) of section 521-3.4 of this SubPart.

(c) Where the person is required to pay interest, interest shall accrue on the amount of the overpayment as determined by OMIG, in whole or in part, in accordance with the provisions of section 518.4 of this Title.

(d) OMIG may recover the overpayment in accordance with Part 518 of this Title or by any other mechanism authorized by law.

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