Last year, as part of the 2020-2021 budget, the New York State Legislature made significant changes to the NYS Mandatory Compliance Program requirement.
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New York State Office of the Medicaid Inspector General (OMIG) annual 2018-2019 Work Plan highlights three areas of concern for the agency: (1) provider compliance; (2) identifying and addressing fraud, waste and abuse in the program; and (3) improving methods of detecting fraudulent activities. 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. The Centers for Medicare & Medicaid Services (CMS) has once again proposed new rules which would enhance the screening requirements for providers and suppliers. The rule proposals would ratchet up the scrutiny on provider enrollments and toughen suspension and revocation penalties. 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. 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. In August, the New York State Inspector General (OMIG) denied enrollment to a pharmacy after an on-site inspection revealed several deficiencies. An apparent egregious case of non-compliance serves as a vivid reminder of why providers must comply with their professional requirements as well as why they must observe NYS Medicaid rules and regulations at all times. 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. 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. 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 The New York Medicaid Program pays costs of all emergency ambulance and medically necessary non-emergency transportation, as well as the necessary transportation expenses for Medicaid enrollees who must travel an extraordinary distance to receive medical care. The New York Medicaid Program will only reimburse transportation providers if specific records verifying an occurrence of a trip are maintained for each leg of the trip. If a New York doctor accepts Medicaid and practices in New York that may be enough be included an audit program conducted through a project known as Payment Error Rate Measurement Program (PERM). When a provider participates in the New York State Medicaid Program, a provider agrees to accept payment as payment in full for the provided services. The same applies to providers who accept Medicaid Managed Care or Family Health Plus (FHPlus) plans. 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 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 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 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 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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