As of April 23, 2017, Medical Answering Services, LLC (MAS) will serve as the Medicaid transportation manager for the New York City region. This region includes New York, Kings, Richmond, Queens, and Bronx counties. MAS currently serves 2,000,000 Medicaid enrollees in 55 counties in the Hudson Valley, Finger Lakes, Northern New York, and Western New […]
On April 17, 2017, the United States Government Accountability Office (GAO) released a report about the current state of Medicaid program integrity. GAO conducted a study of the Medicaid program due to concerns about improper payments and was asked to conduct a study of the Centers for Medicare & Medicaid Services (CMS) to determine the […]
The New York State Office of the Medicaid Inspector General (“OMIG”) has released its annual Work Plan for fiscal year 2017-18. The annual Work Plan offers providers insight into OMIG’s areas of focus in the New York State Medicaid program for the upcoming year. As stated in the Work Plan, the OMIG’s overall mission “is […]
Today, New York Governor Andrew Cuomo announced that $50 million in funding from the state’s Expanded In-Home Services for the Elderly Program has been awarded to the state’s county-based Area Agencies on Aging for the purpose of helping New York’s senior citizens to obtain home health care services. The press release states that the funding “will […]
In a decision that is poised to have resonating implications for health services providers, the Supreme Court of the United States explicitly endorsed the “implied false certification theory of liability” under the False Claims Act (FCA) in Universal Health Services, Inc. v. U.S. ex rel. Escobar. Under this theory of liability, any person who submits […]
In the post-recession world of tighter credit, the close management of payment cycles, accounts receivable, payables, debt and financing obligations, and cash flow has become even more critical to maintaining healthy businesses. Management of these issues also impacts the successful start-up of new practices, facilities or acquisitions. While these issues apply equally to healthcare market, […]
This week, the New York State Comptroller, Thomas P. DiNapoli, issued audit findings which claimed that the New York State Department of Health (“DOH”) failed to capture $95,100,000 in prescription drug rebates it was eligible to receive on drugs administered through the New York State fee-for-service program and the Medicaid Managed Care program from April […]
The Centers for Medicare and Medicaid Services (“CMS”) is soliciting topics for new safe harbors and special fraud alerts. The solicitation appeared in the December 23, 2015 Federal Register, and is made each year. Interested commenters have 60 days to submit their proposals. The solicitation may be viewed here.
The New York State has delayed implementation of Behavioral Home and Community-Based Services (“HCBS”) outside of New York City. These new services were scheduled to begin on July 1, 2016, but are now slated to be phased in three months later, on October 1, 2016. Non-HCBS behavioral health care services will be offered through Medicaid […]
New York State Comptroller Thomas DiNapoli today released an audit of Social Adult Day Services (“SADS”) programs in New York State. The audit is available here. Among other recommendations, the Comptroller asks the New York State Department of Health and New York State Office for the Aging to consider more closely regulating these programs.