9 CRR-NY 9800.3NY-CRR

STATE COMPILATION OF CODES, RULES AND REGULATIONS OF THE STATE OF NEW YORK
TITLE 9. EXECUTIVE DEPARTMENT
SUBTITLE KK. PROGRAM FOR ELDERLY PHARMACEUTICAL INSURANCE COVERAGE
PART 9800. ENROLLMENT OF PHARMACIES
9 CRR-NY 9800.3
9 CRR-NY 9800.3
9800.3 Duties of the provider.
By enrolling, the provider agrees:
(a) to prepare and to maintain contemporaneous records demonstrating its right to receive payment under the program and to keep, for a period of three years from the date care, services or supplies were furnished, all records necessary to disclose the nature and extent of services furnished and all information regarding claims for payment submitted by, or on behalf of, the provider, and to furnish such records and information, upon request, to the contractor, the panel, executive director, or agents and designees;
(b) to comply with the disclosure requirements with respect to ownership and control interests, significant business transactions and involvement with convicted persons;
(c) to accept payment from the program as payment in full for all covered drugs billed under the program, except where specifically provided in law to the contrary with respect to required copayments;
(d) not to illegally discriminate on the basis of handicap, race, color, religion, national origin, sex or age;
(e) to submit claims for payment only for covered drugs actually furnished and which were provided to eligible persons;
(f) to submit claims on officially authorized claim forms in the manner specified by the contractor in accordance with the standards and procedures for claims submission;
(g) to permit audits, by the persons and agencies denominated in subdivision (a) of this section, of all books and records or, in the discretion of the auditing agency, a sample thereof, relating to services furnished and payments received under the program;
(h) that the information provided in relation to any claim for payment shall be true, accurate and complete; and
(i) to comply with the rules, regulations of the program and official directives of the contractor and the executive director.
9 CRR-NY 9800.3
Current through September 15, 2021
End of Document

IMPORTANT NOTE REGARDING CONTENT CURRENCY: JULY 31, 2023, is the date of the most recently produced official NYCRR supplement covering this rule section. For later updates to this section, if any, please: consult editions of the NYS Register published after this date; or contact the NYS Department of State Division of Admisnistrative Rules at [email protected]. See Help for additional information on the currency of this unofficial version of the NYS Rules.