Purpose & Introduction

Purpose of the Attestation
The following Attestation must be completed by all performing providers (hereinafter also referred to as “Partners”) in the NYC Health + Hospitals sponsored OneCity Health (“OneCity Health”) Performing Provider System (“PPS”). The information provided by Partners in this Attestation will be utilized by OneCity Health to: (i) assess the compliance program integrity of its Partners; and (ii) satisfy OneCity Health’s Delivery System Reform Incentive Payment (“DSRIP”) Program compliance oversight obligations as they relate to the allocation of DSRIP funds.
 What Information does the Attestation Require each Partner to Disclose?
OneCity Health hereby requests that all Partners disclose the following compliance-related information, which is outlined in this Attestation: 
(i) The status of completion of DSRIP compliance training by their medical practice or organization (hereinafter “Organization”);
(ii) An acknowledgment by Partners that their workforce members are familiar with and adhere to the NYC Health + Hospitals Principles of Professional Conduct (“POPC”); and
(iii) Proof of New York State Office of the Medicaid Inspector General (“OMIG”) compliance program-related certifications by those Partners that are required by law and/or OMIG policy to submit such certifications.
When Must Partners Return the Attestation?
The Attestation must be completed and electronically signed by an authorized signatory of each Partner as required in your notification. If for any reason an Organization cannot complete this Attestation electronically, it may be printed and returned by email, fax, or mail to the NYC Health + Hospitals/OneCity Health Office of Corporate Compliance (“OCC”) at: 

160 Water Street, Suite 1129
New York, New York 10038
compliance@nychhc.org
Tele: 646-458-5632
Fax: 646-458-5624

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