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.

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, […]

CMS Audit of OPWDD ICFs Seeks Recovery of $1.26 Billion from New York State

New York State is appealing to the Secretary of the United States Department of Health and Human Services (“HHS”) for reconsideration of a July 25, 2014 Centers for Medicare and Medicaid Services (“CMS”) final audit report that found the State liable for $1,257,499,670 in federal Medicaid overpayments.  In its letter to the State, CMS indicated […]

NYC HRA Sued under False Claims Act by Whistleblower; Settles with US DOJ for $1.05 Million

According to United States Attorney Richard S. Hartunian, the City of New York (NYC) has agreed to pay the United States Department of Justice (US DOJ) $1.05 million to settle allegations that the NYC Human Resources Administration (HRA) violated the federal False Claims Act by causing various managed care organizations (MCOs) to provide Medicaid coverage […]

Experienced Nurse Practitioners Will Have More Flexibility with Collaborators in 2015

There’s some cautiously good news for nurse practitioners in New York State: nurse practitioners with about two years of experience will no longer have to complete written practice agreements with physicians, beginning in 2015.  Instead, experienced nurse practitioners will need to have a “collaborative relationship” with either a physician in the nurse practitioner’s specialty or […]

Office of the Medicaid Inspector General Releases 2014-2015 Work Plan

The New York State Office of the Medicaid Inspector General (“OMIG) has released its State Fiscal Year 2014-2015 Work Plan. You can find the press release at: http://www.omig.ny.gov/latest-news/764-2014-15-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 within the Medicaid […]

The OMIG At Work: A Year Of Record Recoveries?

The New York State Office of the Medicaid Inspector General (OMIG) has announced that it has recovered $851 million in Medicaid funds for 2013.  If accurate, this amount will have set a new record (the prior record is claimed to have been $468 million for 2012) for the OMIG in a state where over $53 […]

OMIG Posts Assisted Living Program Audit Protocols

The New York State Office of the Medicaid Inspector General (OMIG) has released its final audit protocols for Assisted Living Programs (ALPs). These protocols became effective November 22, 2013 and are the OMIG’s audit tool that they will use when conducting their audits of ALPs.  The protocols contain 22 areas of potential disallowances based upon […]