Description: This Webinar provides information for members of boards of directors and other governing bodies to understand their role in the healthcare compliance process. The speakers discuss compliance definitions and regulations, as well as examples of ways in which compliance officers and members of governing bodies can communicate to enhance compliance programs for Medicaid providers.
Description: This Webinar outlines the statutory and regulatory requirements under New York State's Medicaid program for the annual compliance certification obligation for both the state requirements and those for the federal Deficit Reduction Act (DRA) of 2005. The speaker demonstrates the new forms for 2013 and explains statutory and regulatory requirements. Finally, the speaker engages in a short discussion on the compliance program review process used by OMIG in assessing the compliance programs of Medicaid providers.
Description: On December 19, 2012, from 2-3:30 pm, the New York State Office of the Medicaid Inspector General (OMIG) will present "The OMIG Exclusion and Reinstatement Process," a Webinar that will provide an overview of the exclusion process that takes place whenever OMIG considers a provider or individual person for exclusion from the program.
This Webinar is free and open to all. Please feel free to invite your colleagues.
OMIG Webinar #15 - OMIG's New Compliance Program Review Assessment Form and Compliance Program Review Process.
Description: This Webinar outlines the statutory and regulatory requirements under New York State's Medicaid program for the compliance obligation and what must be present for Medicaid providers to meet that requirement. The new compliance program review assessment form is discussed, focusing on how it interrelates to the statutory and regulatory requirements and what specific uses providers can make of the form by tailoring it to their own needs. Finally, the speaker engages in a short discussion on the compliance program review process used by OMIG in assessing the compliance programs of Medicaid providers.
- Presentation Slides: PowerPoint Version | PDF Version
- Recording of the Presentation: slides with audio broadcast
- Compliance Program Assessment Form: PDF version
- Follow-up Questions and Answers: here
- Attorney CLE Application - Please fax completed forms to Elana Andrew at: 518-474-6773
Please note: The Compliance Program Assessment Form that was the subject of the Webinar #15 has been updated since the recording of Webinar #15. If you wish to access a MS Word version of the current Compliance Program Assessment Form, OMIG suggests that you access the Form in the "Forms" section of the Compliance Library. The Compliance Library can be accessed under the Compliance tab on OMIG's website.
Description: The Office of Medicaid Inspector General (OMIG), in conjunction with the New York State Health Care Providers (HCP) and the University of Massachusetts Medical School (UMMS), hosted this Webinar to offer education to providers on how to comply with traditional Medicaid/Medicare demand billing requirements post Third-Party Liability (TPL) demonstration project. The Webinar reviews traditional Medicaid billing procedures, including how to report Medicare determinations to UMMS, as well as the status of the TPL demo.
In addition, the OMIG reviews general NYS Medicaid home health billing regulations, along with the billing policies, and provides relevant resource sites.
OMIG Webinar #14 - Certification for 2011: What Every Provider Needs to Know about Changes to the OMIG Certification Process
Description: In October 2009, New York State became the first in the nation to require Medicaid providers who fall under Article 28 and 36 of the Public Health law and Article 16 and 31 of the Mental Hygiene Law or who bill, order or receive more than $500,000 annually to certify that they have an effective compliance program in place. This certification is accomplished through an on-line process on OMIG's Web site and must be done upon enrollment and every December thereafter.
Similarly, since 2007, the federal government has required Medicaid providers who bill, order or receive more than $5 million annually to certify, under the Deficit Reduction Act (DRA), that they have instituted established written policies and procedures informing and educating their employees, contractors and agents about provisions of the DRA. This is to take place by January 1 annually. This certification is a separate process, but is also accomplished via OMIG's Web site.
These requirements are separate from, but related to, the mandatory provider compliance programs under New York Social Services Law § 363-d (SSL).
This Webinar explores changes in the certification process, including legal and regulatory requirements under New York Social Services Law and federal DRA requirements. OMIG Bureau of Compliance representatives discuss the role that the federal employee identification number (FEIN) plays in the certification process, and how to use this number correctly. Additionally, the Bureau explains how it will use this certification process as an opportunity for the provider community to aid in identifying services bureaus that may have not taken the correct steps to enroll as Medicaid providers.
Bureau of Compliance staff demonstrates how to fill out the online forms and uses a step-by-step presentation that providers may follow in completing the forms for SSL 2 011 form and DRA 2012 form.
Additionally, Bureau of Compliance staff explains other changes and enhancements made to the form and certification process, all of which are aimed at making the process more user-friendly and enabling OMIG to collect crucial information about providers' compliance programs.
Description: The federal Affordable Care Act (ACA) of 2010 contains many important elements that impact healthcare providers now and will continue to have further implications in the future.
Under Section 6402(h), providers with "credible allegations of fraud" face possible suspension of all government-based payments under Medicaid and Medicare until those allegations are settled.
This Webinar presents an overview of the Medicaid payment implications of 6402(h), and discusses the Office of the Medicaid Inspector General's (OMIG) collaboration with other state agencies and Medicaid providers, to manage implementation of this new law.This Webinar offers a discussion of the complete process, and presents the requirements of 6402(h) as specified in the law.
OMIG Webinar #12 - Preventing, Addressing, and Reporting Abuse and Neglect in the Care and Treatment of Individuals with Developmental Disabilities
Courtney Burke, Commissioner, Office for Persons with Developmental Disabilities
Jim Sheehan, Former Medicaid Inspector General
Monica Hickey-Martin, Special Deputy Attorney General, Medicaid Fraud Control Unit
Description: This Webinar reviews governing law, compliance requirements and expectations for public agencies and private providers of residential and treatment services for these consumers.
The incidence of abuse and neglect among individuals with disabilities is significantly higher than for their non-disabled peers. New York State has developed and has recently strengthened systems to address these issues, and to respond promptly and effectively to allegations of abuse.
In this webinar, Commissioner Burke addresses the OPWDD's reporting requirements for reportable incidents, serious reportable incidents, and allegations of abuse, set forth in 14 NYCRR 624 and the newly revised Part 624 Handbook and Form OPWDD 147.
Commissioner Burke and Inspector General Sheehan discuss the relationship between abuse and neglect concerns and the Medicaid requirements for an effective compliance program, practical guidance for an effective compliance program under 18 NYCRR 521.3 (a), for OPWDD providers, including
- medical necessity and quality of care;
- mandatory reporting;
- other risk areas that are or should with due diligence be identified by the provider.
Commissioner Burke, Former Medicaid Inspector General Sheehan, and Deputy Attorney General Hickey-Martin discuss the cooperative work of OPWDD, the Commission on Quality Care (CQC), OMIG, and MFCU in identifying individuals who have engaged in abuse and neglect, and developing evidence and witnesses needed to prevent a recurrence, to terminate such individuals from direct-care responsibilities in their employing organization, to exclude such individuals from the Medicaid program , and to pursue criminal prosecution, where appropriate.
Deputy Attorney General Hickey-Martin discusses the patient protection and abuse and neglect prosecutions undertaken by her office, and talk about some of the investigative and case techniques which have been the basis for successful prosecutions.
The speakers cover the role of whistleblowers and advocates in bringing cases forward and assuring that they are appropriately addressed.
Description: This Webinar covers a number of issues relating to the provision of dental services to Medicaid enrollees in New York State.