Harris Beach expects the New York State Office of the Medicaid Inspector General (“OMIG”) to begin performing compliance program reviews this month on a wide cross-section of Medicaid providers that are required to have in place an effective compliance program meeting the requirements of New York State’s recently revised compliance program regulations. We understand that during July, OMIG will send out the first wave of letters to numerous “required providers,” informing them their compliance programs will undergo review by OMIG.

New York’s revised compliance program regulations took effect on Dec. 28, 2022, and are significantly more detailed than the prior regulatory framework. Providers were afforded a 90-day grace period to bring their existing compliance programs into compliance with the new rules before OMIG’s enforcement efforts would begin. Now that the grace period has ended, OMIG is wasting no time in beginning its reviews. We anticipate that OMIG’s initial group of reviews will include providers of varied types and characteristics (i.e., differing sizes, complexities, resources and cultures).

Harris Beach’s Health Care Industry Team performs compliance program reviews, assessments and gap analyses. We assist our clients in developing compliance programs and supporting policies, procedures and standards of conduct; and routinely work with OMIG on compliance, audit and investigation-related issues. The compliance team is led by Health Care attorneys Peter M. Hoffman and Matthew D. Babcock. Matt is the former Assistant Medicaid Inspector General who managed the Compliance Bureau at OMIG, and has served both as a compliance officer and as a compliance attorney in private practice. Peter has been creating, implementing and advising on compliance programs since 1996 for hospitals, health systems, academic medical centers, physician groups, diagnostic and treatment centers, nursing homes, home care agencies, health homes, clinical laboratories and many other provider and supplier types.

Please feel free to contact Peter at phoffman@harrisbeach.com and 516-880-8112, or Matt at mbabcock@harrisbeach.com and 518-701-2780 if you receive a compliance program review letter from OMIG, or if you would like Harris Beach to assist with any other compliance-related questions or issues. 

This alert is not a substitute for advice of counsel on specific legal issues.

Harris Beach has offices throughout New York state, including Albany, Buffalo, Ithaca, Long Island, New York City, Rochester, Saratoga Springs, Syracuse and White Plains, as well as Washington D.C., New Haven, Connecticut and Newark, New Jersey.