Self-Disclosure Submission Information and Instructions

Overview

The federal Affordable Care Act requires providers to report, explain, and repay overpayments within 60 calendar days of identification.

The Self-Disclosure Form may be submitted to OMIG's Self-Disclosure Unit via the Hightail Secure Uplink site.

To submit a completed Self-Disclosure Form using the Hightail Secure Uplink site, please follow the steps below:

1. Visit OMIG’s Hightail Secure Uplink site.
2. Drag the completed Self-Disclosure Form as well as any attachments to the Hightail uplink window or use the “ADD FROM MY COMPUTER” button.
3. Include the following information:

•   Your Name
•   Your Email address
•   Message

4. Click on the “UPLOAD” button

Your form and attachments will be securely uploaded to OMIG’s Hightail Secure Uplink site. Upon successful submission of the form and attachments, you will receive a confirmation email, which will include a link to access any uploaded files and attachments.

Additional information about Hightail and HIPAA Compliance.

To submit a Self-Disclosure by mail:

Please provide a completed Self-Disclosure Form, and include a Claims Data File on CD or other secure device, and send to:

Office of the Medicaid Inspector General
Attention:  Self-Disclosure Unit
800 North Pearl Street
Albany, NY 12204

Contact OMIG's Self-Disclosure Unit by email at: [email protected] or by phone at: 518-402-7030.