OMIG Proposes Regulations Concerning Withholding of Medicaid Payments in Cases of Allegations of Fraud

The New York State Office of the Medicaid Inspector General has proposed new regulations regarding the withholding of Medicaid payments to health care providers in cases where fraud has been alleged.  The proposed rule appears in this week’s New York State Register, which is available here.  An analysis of the proposed rule is forthcoming.

New York State’s Efforts to Reform Out-of-Network Payments

The New York State Legislature introduced a bill (S.5068A/A.7489B) to address benefit coverage for out-of-network care by health insurers.  The stated purpose of the bill is to protect enrollees that purchase premiums to permit choice and cover the cost of treatment by out-of-network providers, but who are still faced with sometimes expensive and unexpected out […]

OIG Releases Report on Medicaid Rates for New York State-Operated Developmental Centers

The Office of Inspector General (“OIG”) released a report yesterday based on its review of the reimbursement rates for New York State-operated developmental centers.   The report found that the Medicaid daily rate for state-operated developmental centers was inflated, and that New York State (State) received $700 million more in federal funding in fiscal year 2009 […]

Gov. Cuomo Releases Proposed Regulations to Limit Executive Compensation and Administrative Costs for State-Funded Providers

Governor Andrew M. Cuomo today announced the release of proposed regulations to limit spending for administrative costs and executive compensation at state-funded not-for-profit and for-profit service providers. The press release from Governor Cuomo’s office, along with a link to an example of one of the proposed multi-agency regulations, can be found here. Related Post: Cuomo […]

OMIG 2012-2013 Work Plan: A Brief Overview

“Fighting Fraud.  Improving Integrity and Quality.  Saving Taxpayer Dollars.” This phrase appears on each page of the newly released New York State Office of the Medicaid Inspector General (OMIG) State Fiscal Year 2012-2013 Work Plan. On the Executive Summary page, the OMIG’s stated mission is to “enhance the integrity of the New York State Medicaid […]

NYS Department of Health to Streamline CON Approval Process

The Public Health and Health Planning Council (PHHPC) announced on Thursday, May 10, that the New York State Department of Health (DOH) will begin to streamline its process for approving Certificates of Need (CON).  The Committee was careful to note that this plan is still evolving—it is not yet clear how the cost and financial […]

Gov. Cuomo Proposes New Agency to Protect New Yorkers with Special Needs

On Monday, May 7, Governor Cuomo proposed legislation for a new agency to protect New Yorkers with special needs.  If the legislature approves of the bill, called the “Protection of People with Special Needs Act,” the proposed Justice Center for the Protection of People with Special Needs would be up and running by April 1, […]

Supreme Court Upholds Applicability of Federal Arbitration Act to Predispute Nursing Home Arbitration Agreements

The use of arbitration clauses in nursing home admission agreements is a growing trend.  In some states, however, there is bias against the enforcement of such clauses, particularly those adopted prior to the occurrence of the events that give rise to the dispute.  Some state courts have gone so far as to hold that predispute […]

AG’s Leadership Committee on Nonprofit Revitalization Proposes Less Bureaucracy and More Transparency for NY Nonprofits

On February 16, 2012, the New York Attorney General’s Office released the recommendations of the Leadership Committee for Nonprofit Revitalization.  The report recommended numerous regulatory changes.  In an effort to make New York a more hospitable environment for nonprofits, the proposals seek to lift the archaic administrative and financial burdens placed on these organizations while […]