The purpose of this bulletin is to provide accounting guidance to counties for Medicaid-related intergovernmental transfers (IGTs). Medicaid-related IGTs are funds that are transferred from counties that own or operate health-related facilities (e.g. hospitals, nursing homes, mental health clinics, etc.) to the New York State Department of Health (NYSDOH). These funds, along with the funds provided by the federal government, are used to fund the Medicaid payments made by the NYSDOH directly to the counties.