The Office of the Medicaid Inspector General (OMIG) Posts 2014 Compliance Program Certification Information and Forms

It’s that time of year again when Medicaid providers who are required to have an effective Medicaid Compliance Plan have to so certify to the OMIG. The on-line certification can only be done during the month of December. 2014 Compliance Program Certification information and forms for the December 2014 certification period are now posted on […]

CONFIRMED The Guard is Changing: James Cox is Leaving OMIG’s Top Spot

Earlier this week, we blogged about postings found on job-search sites Monster.com and indeed.com advertising that New York State is now accepting applications for the Medicaid Inspector General, the head of the state agency charged with combating fraud, waste, and abuse in the State’s Medicaid program.

The Changing of the Guard? The Search for a New Medicaid Inspector General

It appears that Governor Cuomo’s office is looking to replace New York State Medicaid Inspector General James C. Cox. An internet posting seeking applications for the position of the Medicaid Inspector General (MIG) was seen on Monster.com and also indeed.com.

SCOTUS Grants Cert in King v. Burwell

In what could be very important news this afternoon regarding the Patient Protection and Affordable Care Act (“PPACA,” or more commonly called “Obamacare”), the Supreme Court of the United States announced that it was granting certiorari in the case of King v. Burwell, decided on July 22, 2014, by the United States Court of Appeals […]

The Federal Government Adds an Additional $23 Million to New York State’s Medicaid Bill

As far as the Federal government is concerned, it appears that New York is running up quite a bill in claimed overpayments to its Medicaid program.  After finding the State liable for nearly $1.26 billion in overpayments related to intermediate care facilities operated by the Office for People with Developmental Disabilities (“OPWDD”), the United States […]

The OMIG Releases Annual Report for 2013: A Year of Record Recoveries

The New York State Office of the Medicaid Inspector General (OMIG) has released its 2013 Annual Report (“Report”). The OMIG announced that it has recovered a record $879 million in Medicaid overbillings for 2013.  More than $226 million of Medicaid overbillings were identified through audit activities. According to the Report, over the last three years, […]

The Rise of the Worthless Services Theory in Federal False Claims Act (Whistleblower) Cases – A Look to the Future

The theory of “worthless services” has yet again been tried by whistleblowers in the federal False Claims Act context, this time resulting in a large settlement with the federal government.  We saw this argument made previously in Ashber v. Momence, which we discussed in a prior article here.  Now, Extendicare Health Services Inc., and its […]

New Reporting Requirements under the IMPACT Act for Post-Acute Care Providers

President Obama signed into law on October 6th, 2014 the “Improving Medicare Post-Acute Care Transformation Act of 2014”, also known as the “IMPACT Act of 2014”.  The IMPACT Act of 2014 amends the Social Security Act to require home health agencies, skilled nursing facilities, inpatient rehabilitation facilities, and long-term care hospitals to report on a […]