OMIG today posted the following protocols on its website. Hospital Outpatient Department (OPD) Ordered Ambulatory/Laboratory ServicesHospital Outpatient Department (OPD) Emergency Room/Clinic ServicesHospital Outpatient Department (OPD) Ordered Ambulatory Services/Other Than LaboratoryTo view these protocols, please visit: Audit Protocols | Office of the Medicaid Inspector GeneralRead More
The New York State Office of the Medicaid Inspector General (OMIG) is committed to keeping you informed about the agency’s Medicaid program integrity initiatives. To get the latest agency news and information directly in your inbox, subscribe to the OMIG Update today!As a subscriber, you’ll receive: Important announcements about Medicaid compliance, self-disclosures, audit protocols,…Read More
To provide additional information and resources to assist the provider community, OMIG today posted a new protocols page on its website. The enhanced site includes information about the protocol development process, details on service dates and a protocol development planner. The new site also features an archive section, which provides users access to previously posted protocols.To view the new…Read More
If you have lost your federal job due to cuts, or just want to get out, New York says "You're Hired!"Did you know that New York State has more than 7,000 current job openings in a wide range of career fields—something for everyone!New York values its state workforce, providing a host of benefits, including a nation-leading Paid Parental Leave policy. New York…Read More
Effective February 24, 2025, restriction edits supporting the Recipient Restriction Program (RRP) have been restored. As a result, a restricted recipient will be required to obtain all of their care, directly or by referral, from their assigned providers.An assigned Primary Care Provider (PCP) is responsible for providing direct medical care or coordinating care through referral to another…Read More
A medical clinic operator convicted in March 2020 after pleading guilty to grand larceny in the first and second degrees has been sentenced for his role in fraudulently billing Medicaid millions of dollars for medical testing services.Imran Shams, 66, of California, was sentenced Feb. 5 by Judge Michele Rodney of New York County Supreme Court to serve eight years and four months to 25 years in…Read More
The New York State Office of the Medicaid Inspector General (OMIG) today released its 2025 Work Plan, which outlines key Agency program-integrity initiatives planned for 2025. Reflecting OMIG’s commitment to education, engagement and collaboration with Medicaid program stakeholders, the 2025 Work Plan provides a comprehensive roadmap for citizens, policymakers, providers and managed care…Read More
Attention Managed Care Organizations:The Office of the Medicaid Inspector General (OMIG) has issued the Matrix for the next round of Managed Care Program Integrity Reviews, which will be conducted with a review period of calendar year 2023. Reviews evaluate a Managed Care Organization’s performance regarding certain obligations outlined in the Medicaid Managed Care Model Contract. The Matrix, as…Read More
The New York State Office of the Medicaid Inspector General (OMIG) published on its website today the presentation slides from the Fall 2024 Health Care Provider Engagement Forum sessions held Nov. 18 in Albany and Dec. 18 in New York City.To view the presentation slides, please visit: https://omig.ny.gov/information-resources/webinars.Read More
Five Medicaid transportation operators indicted in June 2024 following OMIG-assisted investigations pleaded guilty last week for defrauding the Medicaid program of more than $4.4 million through fictitious billing, kickback schemes and money laundering.Muhammad Rizwan Khan, 38, Muhammad Usman Khan, 40, and Farhan Khan, 29, all of Orange County, and their related Medicaid transportation companies…Read More