New York S 4955: Relates to the functions of the Medicaid inspector general with respect to audit and review of medical assistance program funds

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S04955 Summary:

BILL NOS04955B

&nbsp

SAME ASSAME AS A01069-B

&nbsp

SPONSORHARCKHAM

&nbsp

COSPNSRADDABBO, BORRELLO, FERNANDEZ, GALLIVAN, HELMING, JACKSON, MAY, MAYER, RHOADS, RIVERA, ROLISON,
 SEPULVEDA, SUTTON, WEBB

&nbsp

MLTSPNSR

&nbsp

Amd §§30-a & 35, add §37, Pub Health L

&nbsp

Requires the Medicaid inspector general to comply with standards relating to the audit and review of medical assistance program funds.

Go to top S04955 Actions:

BILL NOS04955B

&nbsp

02/14/2025REFERRED TO HEALTH

03/04/2025AMEND (T) AND RECOMMIT TO HEALTH

03/04/2025PRINT NUMBER 4955A

05/20/2025REPORTED AND COMMITTED TO FINANCE

06/09/2025COMMITTEE DISCHARGED AND COMMITTED TO RULES

06/09/2025ORDERED TO THIRD READING CAL.1625

06/10/2025PASSED SENATE

06/10/2025DELIVERED TO ASSEMBLY

06/10/2025referred to ways and means

01/07/2026died in assembly

01/07/2026returned to senate

01/07/2026REFERRED TO HEALTH

02/25/2026AMEND AND RECOMMIT TO HEALTH

02/25/2026PRINT NUMBER 4955B

03/17/2026REPORTED AND COMMITTED TO FINANCE

05/12/20261ST REPORT CAL.1051

05/13/20262ND REPORT CAL.

05/14/2026ADVANCED TO THIRD READING 

06/01/2026PASSED SENATE

06/01/2026DELIVERED TO ASSEMBLY

06/01/2026referred to ways and means

Go to topS04955 Committee&nbspVotes:

Go to topS04955 Floor&nbspVotes:

There are no Assembly votes for this bill in this legislative session.

Go to topS04955 Text:

 STATE OF NEW YORK
 ________________________________________________________________________

 4955--B

 2025-2026 Regular Sessions

 IN SENATE

 February 14, 2025
 ___________

 Introduced by Sens. HARCKHAM, ADDABBO, BORRELLO, FERNANDEZ, GALLIVAN,
 JACKSON, MAY, MAYER, RHOADS, RIVERA, ROLISON, SEPULVEDA, WEBB -- read
 twice and ordered printed, and when printed to be committed to the
 Committee on Health -- committee discharged, bill amended, ordered
 reprinted as amended and recommitted to said committee -- recommitted
 to the Committee on Health in accordance with Senate Rule 6, sec. 8 --
 committee discharged, bill amended, ordered reprinted as amended and
 recommitted to said committee

 AN ACT to amend the public health law, in relation to the functions of
 the Medicaid inspector general with respect to audit and review of
 medical assistance program funds

 The People of the State of New York, represented in Senate and Assem-
 bly, do enact as follows:

 1 Section 1. Section 30-a of the public health law is amended by adding
 2 three new subdivisions 4, 5 and 6 to read as follows:
 3 4. "Overpayment" shall mean any amount not authorized to be paid under
 4 the medical assistance program, whether paid as the result of inaccurate
 5 or improper cost reporting, improper claiming, unacceptable practices,
 6 fraud, abuse or mistake.
 7 5. "Applicable standards" shall mean the state laws, regulations and
 8 duly promulgated policies, guidelines, protocols and interpretations of
 9 state agencies with jurisdiction in effect at the time the provider
 10 engaged in the regulated conduct or provision of services that the
 11 inspector general is auditing or reviewing.
 12 6. "Clerical or minor error or omission" shall include mathematical or
 13 computational mistakes; transposed procedure or diagnostic codes; inac-
 14 curate data entry; computer errors; duplicate claims; and incorrect data
 15 items, such as provider number, use of a modifier or date of service.
 16 § 2. The public health law is amended by adding a new section 37 to
 17 read as follows:

 EXPLANATION--Matter in italics (underscored) is new; matter in brackets
 [ ] is old law to be omitted.
 LBD02919-07-6

 S. 4955--B 2

 1 § 37. Audit and recovery of medical assistance payments to providers.
 2 Any audit or review of any provider contracts, cost reports, claims,
 3 bills, or medical assistance payments by the inspector, anyone desig-
 4 nated by the inspector to conduct such audit or review, shall comply
 5 with the following standards:
 6 1. Any reviews or audits of provider contracts, cost reports, claims,
 7 bills or medical assistance payments shall apply the applicable stand-
 8 ard. Prior to commencing an audit or review, the inspector shall provide
 9 to the provider access to any applicable standards. For the purpose of
 10 this subdivision, an applicable standard shall not be deemed in effect
 11 if federal governmental