The New York State Medicaid program is projected to have a $62 billion-dollar price tag in State Fiscal Year 2016, with $22.4 billion paid out by the State, as explained by the New York State Office of the Comptroller (“OSC”) in its April 2015 report entitled Ensuring Integrity in New York State Medicaid. As Medicaid continues to transition to a Managed-Care focused program, “maintaining accountability and strengthening program integrity remain[s] critical.”
The New York State Office of the Medicaid Inspector General (“OMIG”) has released its State Fiscal Year 2015-2016 Work Plan. The Work Plan is a road map of where the OMIG intends to go in terms of its anti fraud, waste and abuse efforts with respect to the Medicaid program. The OMIG’s stated mission is […]
The Department of Health has pushed the medical marijuana application deadline back to June 5, from May 29, according to an announcement on the Department’s website: http://www.health.ny.gov/regulations/medical_marijuana/ The Department also announced that it planned to release responses to written questions previously submitted on May 21.
Our monthly Health Law Update from the Albany County Bar Association Newsletter has been released a few days early. This month’s article discusses a Georgia federal court decision granting summary judgment to a nursing home and a rehabilitation therapy provider in a Federal False Claims Act prosecution that alleged the unnecessary provision of rehabilitation therapy services. Although the […]
This month’s article from the Albany County Bar Association Newsletter discusses the New York Attorney General’s recent settlement with Excellus, a Rochester-based health insurer, which resulted from an investigation into complaints from consumers that Excellus was improperly denying claims for mental health and substance abuse treatment. The article also includes a brief overview of New […]
The New York State Office of the Medicaid Inspector General (“OMIG”) has released Compliance Guidance for use by DSRIP (Delivery System Reform Incentive Payment) Performing Provider System (“PPS”) Leads who are in the process of developing and implementing a compliance program. The document highlights special considerations PPS Leads should contemplate for each of the eight […]
This month, the United States Department of Health and Human Services Office of the Inspector General (“HHS OIG”) released its audit report for Ulster County’s 24-hour personal care services program.
In 2011, the United States Department of Health and Human Services Office of the Inspector General (“HHS OIG”) investigated New York City’s Medicaid claims for continuous 24-hour personal care services, an area that previous HHS OIG audits consistently identified as one vulnerable to fraud, waste, and abuse.
This month’s article from the Albany County Bar Association Newsletter offers brief summary of the recent decision in U.S. v. Patel, in which a physician was found to have violated the federal Anti-Kickback statute for an improper referral scheme with a home health agency, even though he did not actively divert patients to other providers. The […]
Medicaid Fraud Control Units (“MFCUs”) have a responsibility to combat Medicaid fraud and patient abuse and neglect. Toward that end, each MFCU maintains statistical data as to the number of investigations, indictments, and convictions by the MFCUs, as well as the amount of monetary recoveries for both civil and criminal cases. Each year, a summary […]