The New York State Office of the Medicaid Inspector General (OMIG) has released its final audit protocols for Dental providers in the Medicaid program. These protocols became effective October 1, 2014 and are the OMIG’s audit tool that they will use when conducting their audits of dental providers. The protocols contain 18 areas of potential […]
As 2014 comes to a close, the United States Department of Justice (“DOJ”) has many reasons to celebrate as it reflects on the year that was. In FY2014, the DOJ recovered $5.69 billion in settlements and judgments resulting from civil fraud and false claims cases, with $2.3 billion in health care fraud recoveries alone. This […]
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 […]
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.
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.
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 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, […]
According to United States Attorney Richard Hartunian of the Northern District of New York, Cardiovascular Specialists, P.C., has agreed to pay the federal government $1,336,636.98 plus interest to settle allegations that it violated the federal Physician Self-Referral Law (also known as the Stark Law) and the federal False Claims Act by knowingly compensating its physicians […]
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 […]
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 […]