OMIG Releases Guidance on Compliance with New Regulations

The New York State Office of the Medicaid Inspector General (OMIG) has issued new guidance to assist providers and managed care plans in implementing recently adopted regulations. The comprehensive guidance covers each component of the new regulations:

• Provider Compliance Programs;
• Self-Disclosure; and
• Medicaid Managed Care Fraud, Waste, and Abuse Prevention Programs. 

The Provider Compliance Program guidance includes a summary of the new requirements and a useful chart at Addendum A comparing the prior regulations with the new regulations. It also includes at Addendum B the requirements of the federal Deficit Reduction Act and the detailed information that OMIG looks for in a Required Provider’s written Policies and any employee handbook when assessing if a compliance program meets statutory and regulatory requirements.

The Self-Disclosure guidance includes an explanation of the requirements and process, Frequently Asked Questions, and submission instructions. The managed care fraud, waste, and abuse prevention programs guidance includes a description of the requirements and forms to be used to implement some of the requirements.

A summary of key elements of the new regulations is here.

Questions regarding the Provider Compliance Program guidance may be directed to OMIG’s Bureau of Compliance at compliance@omig.ny.gov or 518-408-0401. Questions regarding Self-Disclosures may be sent to selfdisclosures@omig.ny.gov. Questions regarding the managed care guidance may be directed to bmfa.mco@omig.ny.gov.

Contact: Karen Lipson, klipson@leadingageny.org