NY’s OMIG Finds Basic Compliance Program Gaps

The Bureau of Compliance (BOC) within the New York State Office of the Medicaid Inspector General (OMIG) recently performed an assessment of providers’ compliance programs. The results indicate that providers sometimes fail in relatively less complicated and readily addressable ways.

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NY Watchdog Releases Its Annual Fraud Fighting Plan

The New York State Office of the Medicaid Inspector General (OMIG or agency) has recently issued its 2017-2018 Workplan. The Workplan identifies key areas of OMIG’s focus impacting health care providers and suppliers.

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Which New York Providers Need a Compliance Program?

New York State Social Service Law §363-d and implementing regulations at 18 NYCRR §521 require that certain healthcare providers adopt and implement an effective compliance program and certify their compliance with the law every December.

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New York OMIG’s Activities By The Numbers

New York Office of the Medicaid Inspector General’s (OMIG) 2013 annual report provides an important insight into the agency’s activities, recoveries and where it plans to focus its resources in the upcoming year.

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OMIG’s 2014-2015 Workplan

The New York State’s Office of the Medicaid Inspector General (OMIG) has released its program of activities for the current fiscal year. As in previous years, the agency’s audit and investigation function remain strong.

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Annual Medicaid Certification Requirement

It’s that time of the year when qualifying providers enrolled with the NYS Medicaid Program must certify that they have a adopted, implemented and maintained an effective mandatory compliance program. The NYS Office of the Medicaid Inspector General (OMIG) is tasked with responsibility of overseeing that providers meet this requirement.

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New York OMIG’s Focus In 2013-2014

Every year the New York State Office of the Medicaid Inspector General (OMIG) publishes a work plan that outlines the agency’s focus in the coming year. As in previous years, the targets of agency’s audits and investigations this work plan cycle remain physicians, dentists, laboratories, transportation providers, pharmacies and DMEs, as well as hospitals and home and community health service providers. Below we discuss some of OMIG’s planned integrity activity.

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Domino Effect of Professional Disciplinary Action

When a healthcare professional faces professional discipline the initial focus tends to be on getting through and beyond the proceeding. Healthcare professionals, however, should also be aware of the collateral consequences that may stem from a professional disciplinary action.

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New York Medicaid Revises The Dental Manual

Recently the New York. State Medicaid Program published an updated version of the Dental Manual as well as the fee schedule. We highlight some of those changes below and encourage all dental providers to analyze the revised documents.

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Pharmacies and DMEs Under Scrutiny By OMIG

The New York State’s Office of the Medicaid Inspector General (OMIG) recently released the agency’s 2012-2013 workplan. The agency’s focus remains firmly on fighting fraud, waste and abuse, compliance and self-disclosure, and provider education. We look closer at how the OMIG plan impacts pharmacy and durable medical equipment (DME) businesses.

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Latest OMIG Plan Outlines New Areas for Medicaid Audits

In the workplan released earlier in the week, the New York State Office of the Medicaid Inspector General (OMIG), which is an independent agency within the Department of Health, renewed its commitment to fighting fraud, waste and abuse in the New York Medicaid Program. One of the nine business lines that the agency will focus

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Governor Cuomo Vetoes OMIG Reform Bill

Many providers were disappointed to learn that on September 23, 2011, New York Governor Andrew Cuomo vetoed a bill that was previously passed without opposition by both houses of the New York State legislature (A.5686-A Gottfried and S.2184-A Little). According to the press release of one of the bill’s sponsors, “[t]he bill would set forth

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OMIG’s Powers To Be Limited By Pending New York Law

A bill introduced in the New York Senate on February 10, 2011, and which passed both of the New York’s State legislative houses in June (A.5686-A Gottfried and S.2184-A Little), is awaiting Gov. Cuomo’s approval. The bill will impact the power of the Office of the Medicaid Inspector General (OMIG) and will address some of

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CMS and OMIG Team Up To Measure Improper Payments

The Centers for Medicare & Medicaid Services (CMS) and the New York State Office of the Mediciad Inspector General (OMIG) have teamed up to analyze and measure whether improper payments in the Medicaid and State Child Health Insurance programs have been made to healthcare providers. Under the Payment Error Rate Measurement (PERM) program, which was

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OMIG Identifies Core Requirements For All Providers

Many New York State healthcare providers have recently felt the heavy hand of the state enforcement agency as the Office of Medicaid Inspector General (OMIG) seeks to recoup payments paid out to providers in an effort to eliminate fraud, waste and abuse in the healthcare industry. At a recent presentation given by OMIG, the agency

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New York State Medicaid Investigators Focusing On Dentists

There is an increased focus on the dental community from the New York State Office of Medicaid Inspector General (OMIG). At an increasing rate, OMIG is conducting audits of dentists and dental specialists, putting additional burden on providers already taxed with other statutory, regulatory and malpractice concerns.

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NYS OMIG Steps Us Its Recovery Efforts: Provider Alert

In order to meet the enhanced program integrity provision of the Affordable Care Act, signed by President Barack Obama in March 2010, as well as the New York False Claims Act signed by Governor David Paterson in August 2010, the Office of The Medicaid Inspector General (OMIG) is ramping up the number of investigations and

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