Audit Protocols

Overview

In consultation with state regulating agencies, OMIG has developed a series of audit protocols to assist the Medicaid provider community in developing programs to evaluate compliance with Medicaid requirements under federal and state statutory and regulatory law.

Audit protocols are applied to a specific fee-for-service provider or category of service in the course of an audit and involve OMIG's application of articulated Medicaid agency policy and the exercise of agency discretion.

These audit protocols are intended to serve solely as guidance and do not alter any statutory or regulatory requirement. In the event of a conflict between statements in the protocols and either statutory or regulatory requirements, the requirements of the statutes and regulations govern.

For reasons such as responding to a hearing decision, litigation decision, or statutory or regulatory change, an audit protocol may be amended.

Assisted Living Program Protocol
Certified Home Health Agency Episodic Payment Protocol
Certified Home Health Agency Protocol
Consumer Directed Personal Assistance Program Protocol
Dental Protocol
Diagnostic & Treatment Center Services Protocol
Durable Medical Equipment Protocol
Early Intervention Program Protocol
Health Home (Adults) Protocol
Hospice Protocol
Hospital Outpatient Department Ordered Ambulatory Other Than Laboratory Protocol
Independent Provider for Private Duty Nursing Protocol
Licensed Home Care Services Agency (LHCSA) for Private Duty Nursing Protocol
Long Term Home Health Care Program Protocol
Nursing Home Transition and Diversion Waiver (NHTD) Protocol
Office for People With Developmental Disabilities (OPWDD) Article 16 Clinic Services Protocol
Office for People With Developmental Disabilities (OPWDD) Day Habilitation Protocol
Office for People With Developmental Disabilities (OPWDD) Day Treatment Protocol
Office for People With Developmental Disabilities (OPWDD) IRA Residential Habilitation Protocol
Office for People With Developmental Disabilities (OPWDD) Medicaid Service Coordination Protocol
Office for People With Developmental Disabilities (OPWDD) Prevocational Services Protocol
Office for People With Developmental Disabilities (OPWDD) Supported Employment Protocol (7/1/15-3/9/16)
Office for People With Developmental Disabilities (OPWDD) Supported Employment Protocol (prior to 7/1/15)
Office of Addiction Services and Supports (OASAS) Inpatient Chemical Dependence Rehabilitation Services Protocol
Office of Addiction Services and Supports (OASAS) Opioid Treatment Program Protocol
Office of Addiction Services and Supports (OASAS) Substance Use Disorder Outpatient Programs Protocol
Office of Mental Health (OMH) Community Rehabilitation Services for Adults Protocol
Office of Mental Health (OMH) Comprehensive Psychiatric Emergency Programs Protocol
Office of Mental Health (OMH) Continuing Day Treatment Services Protocol
Office of Mental Health (OMH) Day Treatment Programs Serving Children Protocol
Office of Mental Health (OMH) Intensive Psychiatric Rehabilitation Treatment Protocol
Office of Mental Health (OMH) Outpatient Clinic Treatment Services Protocol
Office of Mental Health (OMH) Partial Hospitalization Protocol
Office of Mental Health (OMH) SED Services Family Support Services Protocol
Office of Mental Health (OMH) SED Services Individualized Care Coordination Protocol
Office of Mental Health (OMH) SED Services Respite Services Protocol
Office of Mental Health (OMH) SED Services Skill Building Services Protocol
Personal Care Aides Protocol
Pharmacy Protocol
Preschool & School Supportive Health Services Programs Protocol
Transportation Ambulette Protocol
Transportation Taxi/Livery Protocol
Traumatic Brain Injury (TBI) Protocol