9 CRR-NY 9850.6NY-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 9850. AUDITS AND RECOVERY OF OVERPAYMENTS
9 CRR-NY 9850.6
9 CRR-NY 9850.6
9850.6 Final audit report.
(a) After receipt of the provider's objections to the draft audit report, or at any time after the expiration of 40 days after mailing of the draft audit report without objections having been received, a final report shall be issued by the executive director. In preparing the final audit report for the executive director, the contractor shall consider the objections, any supporting documents and materials submitted therewith, the draft audit report, and any additional material which may become available.
(b) Upon receipt of a final report from the contractor, the executive director shall conduct a review of the report for conformance with program policy, law and regulations. The report may be modified by the executive director prior to issuance in light of his/her review.
(c) The final audit report and/or the cover letter accompanying it shall clearly advise the provider:
(1) of the nature and amount of the audit findings, the basis for the action and the statutory, regulatory or other legal basis therefor;
(2) of the action which will be taken;
(3) that the effective date of the intended action shall be not less than 15 days from the date of the final audit report;
(4) of the right to appeal the administrative action by requesting a hearing, and the name, title, address and telephone number of the appropriate official of the Office of Administrative Hearings the provider must contact to request a hearing;
(5) that a request for a hearing must be made in writing and postmarked or delivered within 60 days of receipt of the final audit report which shall be presumed to be five days from date of mailing; and
(6) that the request may not address issues regarding the methodology used to determine the rate of payment under the program or the dispensing fee, but shall be limited to those issues relating to determinations contained in the final audit report.
9 CRR-NY 9850.6
Current through September 15, 2021
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