On September 21, 2023, the New York State Office of the Medicaid Inspector General (“OMIG”) posted on its website Compliance Program Requirements Frequently Asked Questions. OMIG intends the FAQs to supplement its Compliance Program Guidance published on January 31, 2023.

The nine-page Compliance Program Frequently Asked Questions document addresses questions related to:

  • General Information
  • Required Providers
  • Compliance Program Requirements
  • Compliance Program Reviews
  • Affected Individuals/Contractors
  • Help and Support

Many of the answers on the FAQs are predictable based upon OMIG’s previously published guidance, but the answer on pages 4 and 5 addresses the question: How will OMIG calculate the average score percentage for a compliance program review? We think this is the first time this has been addressed by OMIG. This score will determine if a compliance program is effective and if it is determined not to be effective, OMIG has statutory and regulatory authority to impose financial penalties for the failure.

Please contact Matthew Babcock at mbabcock@harrisbeach.com if you would like to engage Harris Beach to review your compliance plan or to assist in development of a compliance plan and supporting policies that that meet the new requirements or if you need assistance during or in anticipation of an OMIG Compliance Program Review.

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, New York City, Rochester, Saratoga Springs, Syracuse, Uniondale and White Plains, as well as Washington D.C., New Haven, Connecticut and Newark, New Jersey.