Since the advent of the Medicaid managed care program there has been a lingering question as to when a Medicaid dollar stopped being a Medicaid dollar.
With fee-for-service providers that were paid directly by the Medicaid program, the answer was always clear-cut – each dollar received from the Medicaid program was a Medicaid dollar and therefore it and the provider
Continue Reading 2019 Executive Budget Expands OMIG Oversight Authority
As New Yorkers are preparing for Thanksgiving and the official start to the holiday season (although some could argue it started a month ago), required Medicaid providers should also be reviewing their Compliance Programs in preparation to submit their Annual Provider Compliance Program Certification to the New York State Office of the Medicaid Inspector General (“OMIG”). Required providers must submit
Continue Reading Medicaid Providers: Don’t Forget to Include Your Annual Compliance Program Certification to Your Holiday “To-Do” List.
In Matter of Koch v. Sheehan, the New York Court of Appeals held that the Office of Medicaid Inspector General (“OMIG”) may remove a physician from the Medicaid program based solely on a consent order between the physician and the Bureau of Professional Medical Conduct (“BPMC”), even if BPMC does not suspend the physician’s license and OMIG does not
Continue Reading OMIG May Exclude Physician from Medicaid Even When BPMC Allows Continued Practice
The New York State Office of the Medicaid Inspector General today announced their new Facebook page. This could be the only time anyone in the health care industry might consider a declaration that they “like” the OMIG.
While a Facebook page may appear unusual for this less-than-beloved agency, the OMIG’s office has made several recent attempts to open up
Continue Reading OMIG Announces Facebook Page
Just a reminder to New York State Medicaid providers that certifications under the NYS Social Services Law and the Federal Deficit Reduction Act are due no later than December 31.
All New York State Medicaid providers who are required to have a compliance program under Social Services Law Section 363-d must certify that their compliance programs are effective. The certification
The New York State Office of the Medicaid Inspector General (“OMIG”) recently finalized regulatory changes to New York State law which relate to the withholding of payments to Medicaid providers when there is a “credible allegation of fraud.” A credible allegation of fraud is defined as an “allegation that has indicia of reliability and has been verified by the [OMIG]
Continue Reading OMIG to Withhold Payments for “Credible Allegations of Fraud”
The New York State Office of the Medicaid Inspector General (“OMIG”) recently released its Compliance Program Guidance for General Hospitals. While the OMIG had previously released a Compliance Program Assessment Tool, the new Guidance document provides a far greater level of detail as to the expectations of a hospital’s compliance program.
New York State law (Social Services Law Section
Continue Reading NYS Office of the Medicaid Inspector General Releases Compliance Guidance for Hospitals