Self-Disclosure of Health Care Worker Bonus Payments

Health Care Worker Bonus Self-Disclosure Submission Information and Instructions

Employers who have received an overpayment of Health Care Worker Bonus (HWB) funds are required to report, return and explain that overpayment to OMIG.

Statutory Authority:

  • Social Services Law section 367-w
  • Social Services Law section 363-d

Employers should complete the HWB Self-Disclosure Submission Statement, Certification Statement, and HWB Self-Disclosure Overpayment Report Excel Spreadsheet and submit it via OMIG’s secure uplink here. The Submission Statement requests basic Employer information and contains a link to the embedded HWB Self-Disclosure Overpayment Report Excel Spreadsheet to detail the employee information relevant to the overpayment. 

Please note that the HWB Self-Disclosure Overpayment Report Excel Spreadsheet requires overpayments to be reported individually with one employee and one vesting period per line.

Submission to the secure uplink will generate an automatic reply confirming that your submission has been received by OMIG’s Self-Disclosure Unit.

Employers are required to provide the following information:

  • Employer contact Information
  • Employer Medicaid enrollment information including MMIS ID and NPI or Employer SFS Vendor ID used to claim HWB funds
  • Date the overpayment was identified
  • Vesting Period(s) during which the overpayment was received
  • Employee first, middle, and last name
  • Employee SSN or ITIN
  • Employee date of hire
  • The title claimed for the employee, and the correct title that should have been claimed (if applicable)
  • The employee base yearly salary claimed, and the corrected base salary (if applicable)
  • The employee average hours per vesting period claimed, and the corrected hours (if applicable)
  • The reason for the overpayment. If the reason for your overpayment is not already listed, please choose “other” and include an explanation.
  • The HWB dollar amount received (per employee, per vesting period)
  • The overpayment amount (per employee, per vesting period)
  • A copy of the original Employer Attestation submitted to the HWB Portal
  • Copies of all Employee Attestations related to the overpayment(s) being disclosed
  • Copies of all employee-level Remittance Advice documents related to the overpayment(s) being disclosed

Please note: Employers should return to OMIG the FICA amount as part of the total overpayment for any overpaid HWB funds received.

Once the completed HWB Self-Disclosure Submission Statement, HWB Self-Disclosure Overpayment Report Excel Spreadsheet, and the additional supporting documentation detailed above are received, OMIG’s Self-Disclosure Unit will contact you with a project number for reference and a request for any additional information required to process your disclosure. At the conclusion its review, OMIG will provide you with a Final Letter, which includes instructions on repayment.

If you have questions, please contact OMIG’s Self-Disclosure Unit at [email protected].