LSB 2014-21: Reporting Requirements for Certified/Non-funded providers
Date Issued: October 21, 2021
(First issued November 3, 2014; revised on May 5, 2015 and again October 21, 2021)
RECIPIENT
- All Non-funded OASAS Certified Service Providers
- Local Governmental Units (LGUs)
PURPOSE
The purpose of this Bulletin is to summarize the financial reporting requirements for OASAS certified providers of service (providers) that do not receive net deficit funding (also known as state aid or Aid to Localities funding) and to detail potential sanctions for non-compliance with these requirements. It is important that reporting entities, both service providers and Local Governmental Units (LGUs), fully comply with all informational reporting requirements to help ensure the effective administration of OASAS' statutory responsibilities for regulating and overseeing the substance use disorder and problem gambling service delivery system in New York State.
Most providers of non-funded OASAS certified program services that bill Medicaid for those services are required to electronically submit an annual cost report known as the Consolidated Fiscal Report (CFR). The CFR contains detailed financial information about a provider entity’s OASAS certified programs, entity-wide administrative overhead (agency administration) and an aggregate summary of all non-OASAS, non-agency administration costs.
In addition to the electronic submission of the CFR, non-funded providers must submit signed copies of all applicable CFR certification schedules. OASAS also requires that most non-funded service providers submit independently audited and certified general-purpose financial statements on an annual basis. OASAS reserves the right to request additional substantiating financial information as deemed necessary based on a subsequent CFR desk review.
More specific, detailed information regarding CFR completion and submission requirements can be found in the published CFR Manual located on the New York State Education Department web site.
In addition to the above-referenced reporting requirements, non-funded OASAS certified providers are required to comply with all applicable sections of the OASAS Reporting Requirements for OASAS Reporting Entities.
APPLICABILITY AND AUTHORITY
Pursuant to Articles 19, 25, 32, and 41 of the Mental Hygiene Law (MHL) and 14 NYCRR, Part 841 of OASAS regulations, and in accordance with the standards provided in the CFR Manual, most OASAS-certified providers of substance use disorder and/or problem gambling services are required to report financial and other service-related information to OASAS.
Most non-funded service providers that are certified pursuant to Article 32 of the MHL and/or licensed under Article 28 of the Public Health Law (PHL) and accept Medicaid for one (1) or more of their OASAS programs, are required to submit a Full CFR. All substance use disorder and/or problem gambling programs operated by the service provider must be reported in the CFR. See Section 2.0 of the CFR Manual for OASAS threshold requirements governing CPA certification of Full CFRs and other CFR submission related requirements.
Non-funded OASAS programs licensed under Article 28 of the PHL and operated by a hospital are not required to submit a CFR unless they are otherwise required to submit a CFR as a result of NYS Office of Mental Health (OMH), NYS Office for People With Developmental Disabilities (OPWDD), NYS Education Department (SED), and or NYS Office of Children and Family Services (OCFS) reporting requirements. Non-funded OASAS hospital operated facilities programs that have a CFR reporting requirement for one or more of the other state agencies noted above must include all operational OASAS certified substance use disorder and/or problem gambling programs on OASAS-specific schedules of the required CFR.
DEFINITIONS
A non-funded provider of OASAS certified services is defined as any not-for-profit, for profit, governmental or municipal organization providing OASAS certified substance use disorder and/or problem gambling services that receives no net deficit funding (state aid or Aid to Localities funding) from OASAS. Financial support is derived completely from other sources which may include Medicaid, client fees, health insurance carriers and other third-party payers. This definition may include school districts, individual schools and LGUs.
NON-COMPLIANCE AND SANCTIONS
A non-funded provider of OASAS certified services required to submit an annual CFR shall be considered non-compliant with OASAS Consolidated Fiscal Reporting requirements upon the lapse of the first established due date for the receipt of the required CFR/CFR-related information, or upon the lapse of an OASAS-approved extension of such due date, whichever is later. A service provider will be considered non-compliant with CFR requirements if, by the established or approved extended due date for submission of the required CFR/CFR-related information, it fails to:
- electronically file a CFR for a given annual fiscal reporting period;
- electronically file a proper and complete CFR for a given annual fiscal reporting period in conformance with applicable instructions, policies and/or procedures published in the applicable CFR Manual;
- submit signed copies of all applicable CFR certification schedules for an electronically filed CFR;
- submit independently certified general-purpose financial statements for a given annual fiscal reporting period, if so required in the CFR Manual; and
- submit additional required CFR-related information requested by OASAS.
Effective immediately, a non-funded provider of OASAS certified services that does not comply with established reporting requirements as detailed in the applicable CFR Manual and Reporting Requirements for OASAS Reporting Entities may be sanctioned by imposition of a fine, the withholding of Medicaid revenue, and/or limitation, suspension or revocation of its operating certificate. The provider will not be in Good Standing. The suspension or revocation of a provider’s operating certificate prohibits the operation of any substance use disorder and/or problem gambling program requiring OASAS certification. Suspension or revocation of an OASAS operating certificate also prevents a provider from billing Medicaid, other third-party payers and individual program participants for substance use disorder and/or problem gambling services.
Prior to the imposition of any applicable sanction, the service providers will be notified in writing of the nature of their non-compliance and given the opportunity to correct such non-compliance prior to the imposition of sanctions. Such service providers will be notified of their right to be heard at a hearing when such is required by law.
Upon OASAS' determination that the sanctioned service provider has come into full compliance with all applicable OASAS reporting requirements, OASAS may, at its discretion, lift any sanctions and return the provider to good standing.