CMS Issues Section 1135 Waivers for New York and New Jersey

The Centers for Medicare and Medicaid Services (CMS) approved waivers for New York and New Jersey under Section 1135 of the Social Security Act.  The waivers ease certain legal requirements on healthcare providers who are serving those impacted by Sandy.  The Section 1135 waiver for New York is available here.  The waivers relax the rules […]

OMIG Releases Compliance Alert for Medicaid Providers

The New York State Office of Medicaid Inspector General (“OMIG”) recently released a Compliance Alert that explains what types of Medicaid providers are required to have a compliance program and what steps those providers can take to ensure that they are meeting their obligations under the law. The New York Social Services Law and its […]

United States HHS OIG Reviewing Self Disclosure Protocol for Federal Health Care Programs

The federal government’s Office of the Inspector General (“OIG”), part of the United States Department of Health and Human Services, is considering revising its self-disclosure protocol to provide additional guidance to federal health care program providers.  The OIG is soliciting comments from all sources on the process by which health care providers can report overpayments […]

Governor Cuomo and NY Legislature Reach Agreement on Justice Center for the Protection of People with Special Needs

Governor Cuomo and the New York State legislature reached an agreement late on Sunday, June 17, that is expected to lead to the creation of the Governor’s proposed Justice Center for the Protection of People with Special Needs (“Justice Center”).  The bill, S. 7749/A.10721, will be brought to the Assembly for a vote on Wednesday, […]

Gov. Cuomo Announces Agreement on Justice Center Legislation to Protect People with Special Needs and Disabilities

Today, Governor Andrew M. Cuomo, Senate Majority Leader Dean Skelos, and Assembly Speaker Sheldon Silver announced an agreement on legislation that will establish a new Justice Center for the Protection of People with Special Needs, which will change how the state protects New Yorkers in state-operated, certified, or licensed facilities and programs. As we previously […]

Tax Dollars at Work: Federal Government Spent $102 million in Auditing Fees to Identify Less Than $20 Million in Medicaid Overpayments

The Government Accountability Office (“GAO”) has released a report following its review of the National Medicaid Audit Program.  The GAO has determined that this program, designed to fight Medicaid fraud, has cost the United States at least $102 million in auditing fees since 2008 while identifying less than $20 million in overpayments.  Analysis of the GAO’s findings […]

New York Attorney General Settles Balance Billing and Overpayment Disputes

New York State Attorney General Eric Schneiderman announced on Tuesday that it had reached settlements with Group Health Inc. (“GHI”) and a New York City health care provider regarding overpayments to consumers. GHI has agreed to repay consumers for approximately three years of overbilling.  GHI purportedly charged its assureds out-of-network rates for certain medical providers, […]

NY State Seeks Medicaid Waiver to Redesign Health Care System

Governor Andrew Cuomo announced on Tuesday, June 5, that New York State will seek to spend $10 billion in Medicaid savings to redesign the state’s health care system. The state must ask the Federal Department of Health and Human Services (“HHS”) for a waiver that would allow the state to use up to $10 billion […]

PHHPC Focuses on Cost-Savings in CON Streamlining

On Wednesday, May 24, the Public Health and Health Planning Council (“PHHPC”) met to further discuss the streamlining of the Certificate of Need (“CON”) process in New York State. The PHHPC produced documents that explain the mission and vision for the CON, as well as a report of its recommendations for streamlining the CON program.  Over […]

DOH Issues Guidance on Use of Surveillance Equipment in Nursing Homes

Increasingly, nursing homes seek guidance on the considerations involved in the use of surveillance equipment in their facilities.  On May 22, 2012, the New York State Department of Health issued a “Dear Administrator Letter” (DAL) addressing the use and installation of audio and/or video surveillance equipment in nursing homes.  The DAL is available here.