N.Y. Comp. Codes R. & Regs. tit. 14 § 552.4

Current through Register Vol. 46, No. 45, November 2, 2024

Section 552.4 - Definitions

(a) Abuse means practices that are inconsistent with sound fiscal, business, medical or professional practices and which result in unnecessary costs to the program, payments for services which were not necessary, or payments for services which fail to meet recognized standards for mental health care.

(b) Audit means a review and evaluation of a facility, program or unit by an objective and independent individual or team to determine whether or not resources and/or funds are being utilized in an appropriate and effective manner or to determine whether or not the expected results established by the Office of Mental Health, control agencies, the Legislature or other identified standard setting bodies are being achieved.

(c) Fraud means an intentional deception or misrepresentation made with the knowledge that the deception could result in an unauthorized benefit to the provider or another person and includes the acts prohibited by section 366-b of the Social Services Law.

(d) Provider of service means the entity which is responsible for the operation of the facility or program. Such entity may be an individual, partnership, association or corporation. For purposes of this Part the term also applies to a psychiatric center, facility or program operated by the Office of Mental Health.

N.Y. Comp. Codes R. & Regs. Tit. 14 § 552.4