1. As outlined in our presentation, a provider can qualify if they bill Medicaid through eMedNY and claim through their MMIS number or if they have an SFS they can file using their SFS number. Throughout the webinar it was emphasized that only those entities under certain programs (OMH, OPWDD, OASAS, OCFS or SED(*)) would access under the SFS.
(*it was noted that SED is currently not listed but verbally stated that SED will be working with their agencies to get providers SFS numbers).
For those providers that bill through Medicaid, at least 20% of your service must be to Medicaid enrollees to be a qualified employer under an MMIS or you must be subject to a Certificate of Need Process. NYS will not be providing a specific methodology for this determination but states the onus is on the employer to determine how to calculate this.
NYS DOH included a listing of providers that would be under a certificate of need, which include hospitals, nursing homes, diagnostic and treatment centers, and ambulatory surgery centers.
A provider which does not qualify under the above (e.g. does not service 20% Medicaid or operate under a certificate of need) and have an SFS, you may still be able to qualify under that section of the regulations.
2. Employers will receive FICA and other payroll taxes in addition to the bonus, so employers will not need to go out of pocket for employer portion of the taxes. Each remittance will include a listing of eligible paid employees and a separate “below the line” item for the employer share of FICA Taxes. Prior to this clarification it was believed that employers would be out of pocket for these mandated costs.
3. The NYS DOH guidance says that that employers are not required to match 401(k) or other similar retirement accounts for these bonus payments; however, we would advise you review with your TPA or other professional as the plan document may still require treatment as eligible wages.
4. NYS has also confirmed that there is no state or city withholding requirement for these payments and that providers should work with their payroll vendors to remove these taxes from payments. No further guidance was given on reporting these payments.
5. NYS indicated that there have been a plethora of questions regarding eligibility. A few specific clarifications there were provided include
- Coders, Billers, Call Center Staff, Security Personnel are not eligible
- Infusion nurses from licensed home health agencies, pharmacists and techs in CHHAs/LSHAs and Patient Access Representatives/Coordinators are all eligible
- Medical Records Employees, Access/Call Center and exclusively in a non-patient building are not eligible
Further, NYS has stated there is “no specified amount of time” a worker needs to perform “hands-on clinical” in order to be eligible if they are employed under an eligible title and otherwise meet criteria and that the work need not be in person (e.g. telehealth is acceptable).
6. Former employees that terminate their employment (by their choice) before the due date of the payment period are not eligible. However, if the employer terminates the employment relationship after vesting, the employer is still required to submit a claim and pay to the former employee.
7. NYS has confirmed our belief that employee attestations can be submitted electronically to employers. Attestations need to be collected and retained prior to the submission of a claim. If an employee does not obtain an attestation prior to a submission date, the employer can submit with subsequent vesting periods. As suggested, employers should make reasonable efforts to obtain the attestations and employers need to maintain documentation if an employee declines to sign the attestation.
8. An employer can request one attestation for the period October 1, 2021 through September 30, 2022. This is likely being done to lessen the administrative burden on employers at this time.
9. Employers should submit claims for employees under the MMIS ID that is “most appropriate” for their employment situation, which was clarified to be where they work the most hours. The presenter stated that if an employee works for multiple “entities” the submission should be for the employer that has the most hours worked. This appears to convey that if an employee works for the same consolidated organization, all hours the employee worked for all entities should be aggregated and should be filed under the MMIS number where the employee worked the most.
NYS mentioned throughout their townhall there will be continued updates to the FAQ (typically around Fridays around noon) which we will continue to monitor and send updates accordingly. Additionally, NYS announced 2 additional townhalls on August 26th, 2022 at 11:00am and September 2, 2022 at 11:00am.
Kenneth R. Cerini, CPA, CFP, FABFA
Managing Partner
Ken is the Managing Partner of Cerini & Associates, LLP and is the executive responsible for the administration of our not-for-profit and educational provider practice groups. In addition to his extensive audit experience, Ken has been directly involved in providing consulting services for nonprofits and educational facilities of all sizes throughout New York State in such areas as cost reporting, financial analysis, Medicaid compliance, government audit representation, rate maximization, board training, budgeting and forecasting, and more.
Edward McWilliams, CPA
Partner
Ed is a Partner in the firm’s tax and business advisory practice focusing on providing services to middle market private companies across different industries as well as to early stage startups. Ed has over a decade of experience providing tax and business consulting services to these companies of different sizes and across different industries, bringing a broad and diverse knowledge base and strategic solutions to the many complex issues that businesses face.