- posting new Compliance Alerts or Guidance each day Monday through Friday accessible via our Web site.
- hosting a live tweet session with OMIG's compliance team answering questions about compliance on Wednesday from 1 to 2 P.M. You can contribute to the talk by following us at @NYSOMIG or #complianceNY.
- Tweeting compliance information throughout the week at our Twitter Feed @NYSOMIG and through Facebook and LinkedIn.
Registration information will be posted on the OMIG Web site (www.omig.ny.gov) and will also be sent out via a new listserv message (which you can sign up for here), as well as via Twitter (@NYSOMIG) and OMIG's Facebook page, approximately one week prior to the session. Please forward to interested individuals.
OMIG has also posted some new tips for Medicaid consumers. As an example, Medicaid consumers are reminded that they should check their income levels throughout the year. This tip, along with others will help consumers and other New York State residents to fight Medicaid fraud and abuse.
The New York State Office of the Medicaid Inspector General (OMIG) released its State Fiscal Year 2014-15 Work Plan, highlighting areas of focus in OMIG’s efforts to fight fraud, improve integrity and quality, and save taxpayer dollars. This Work Plan details dozens of programs that will be reviewed over the period of April 1, 2014 through March 31, 2015.
“Taxpayers depend on OMIG to fight fraud, improve integrity, and save taxpayer dollars. Our annual work plan is a roadmap to our efforts over the next 12 months,” said Medicaid Inspector General James C. Cox.
The work organizes OMIG’s work within business line teams (BLTs), an innovation Cox developed within OMIG during the early days of his tenure as Medicaid Inspector General. BLTs consist of establishing teams of personnel with experience within the various parts of OMIG—auditors, investigators, clinicians, attorneys, and technicians—bringing together expertise to focus and expedite work production while simultaneously ensuring accuracy. “BLTs help OMIG to operate with improved efficiency, conduct more thorough reviews and investigations, and tactically deploy resources where they are needed the most,” Cox added. BLT coordination improves referrals to law enforcement and potential prosecution.
OMIG uses BLTs to focus on finding individuals who commit fraud and abuse. Recent actions have included the identification of dozens of fraudulent providers and individuals who will face exclusion from participating in the Medicaid program or even criminal charges because of inappropriate and/or fraudulent acts.
The BLT approach has paid financial dividends. In calendar year 2013, preliminary OMIG recoveries topped $851 million dollars–a new record for OMIG, and the highest ever recovered in a single year by any state.
Recoveries do not tell the whole story of Medicaid program improvement. New York State’s health care providers, as well as their compliance officers, and billing and coding staff, are following OMIG’s lead in strengthening their adherence to the rules of the Medicaid program. “We are committed to ensuring fair consideration to New York’s providers, enrollees, and taxpayers as we fulfill the work outlined in this plan,” said Cox.
Available at the agency’s Web site, the Work Plan for State Fiscal Year 2014-15 reflects work that serves as the foundation for the state’s future efforts as the agency assures that providers meet program quality standards for Medicaid enrollees in a system free of waste, fraud, abuse, and improper payments.
New Yorkers can assist the Office of the Medicaid Inspector General in fighting fraud, waste, and abuse by reporting potentially suspicious behavior or incidents. OMIG encourages anyone who observes instances of potential Medicaid fraud, waste, or abuse to contact OMIG’s fraud hotline at 1-877-87-FRAUD. Tips can be completely anonymous, and OMIG investigates information from all calls.
The mission of the Office of the Medicaid Inspector General is to enhance the integrity of the New York State Medicaid program by preventing and detecting fraudulent, abusive, and wasteful practices within the Medicaid program and recovering improperly expended Medicaid funds while promoting high-quality patient care.
You can help stop Medicaid fraud: Call OMIG’s Fraud Hotline at 1-877-87 FRAUD (1-877-873-7283), or click here to file a complaint electronically.
The OMIG may sanction some providers by excluding them from participating in the Medicaid program. These providers are excluded from offering services to Medicaid enrollees and also cannot be paid with Medicaid dollars. Prior to adding new staff members, employers should check to see if prospective employees have been excluded from Medicaid. To make it easier to perform such a check, OMIG set up a dedicated service to check the status of any exclusion.
Anytime a health care organization discovers that it was paid more than it was due, this should be reported to OMIG. Our Self-Disclosure section provides information for health care organizations to complete the recently revamped self-disclosure process.
30 June 2014
A Nassau County physician, Mark Shaffer, was denied reinstatement into the New York State Medicaid p [ ... ]
Reliance Ambulette, a Flushing, New York -based provider of medical transportation services, overbil [ ... ]
Manor Pharmacy Inc. in Sullivan County applied for enrollment as a provider with Medicaid. After di [ ... ]
Stuart Blankman, a Manhattan optometrist, requested reinstatement into the Medicaid program. New Yo [ ... ]
07 May 2014
Governor Andrew M. Cuomo today announced that New York’s Medicaid program saved taxpayers more tha [ ... ]
07 May 2014
OMIG published Compliance Guidance 2014-02 outlining risk areas by provider type for Certified Home [ ... ]
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