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. [...]
|
|||||
OMIG UpdatesWhen 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. [...] 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. [...] 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.
Continue reading » 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 on during the 2012-2013 fiscal year includes the following three providers: physicians, dentists and laboratories.
Continue reading » 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 standards for the Office of the Medicaid Inspector General (OMIG) audit process in order to protect honest providers and the patients they serve.” The highlights of the bill are discussed here. 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 the practices viewed as unjust by the provider community. Many providers believe that OMIG’s aggressive auditing approach has been unfair and see the office as having “strayed far from the goal of rooting out fraud and encouraging appropriate accountability.”
Continue reading » 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 developed to comply with the Improper Payments Information Act (IPIA; Public Law 107-300) of 2002, each federal agency is required to annually identify programs that may be susceptible to significant and improper payments, estimate the amount of improper payments, submit the estimated amounts to Congress and also submit a report on actions the agency is taking to reduce the improper payments.
Continue reading » 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 identified the following core requirements for all healthcare providers that participate in the Medicaid program:
Continue reading » 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.
Continue reading » 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 audits of the State’s healthcare providers. Even before these laws were implemented, OMIG was under pressure to produce results.
Continue reading » |
|||||
|
|
|||||