The New York State Office of the Medicaid Inspector General (“OMIG”) conducted three statewide sessions to outline its audit process as it pursues its mission to prevent and detect fraud, waste and abuse in the Medicaid program. The sessions included a PowerPoint presentation by the Frank Walsh (Acting Medicaid Inspector General), Erin Ives (First Deputy Medicaid Inspector General), and Jay Speers (Deputy Medicaid Inspector General – Audit). The three sessions included opportunities for providers to comment and ask questions related to OMIG’s audits.

Attached is a link to a copy of the OMIG presentation issued on May 26.

The sessions’ slides address the following topics:

  • OMIG’s authority to conduct audits and recover overpayments
  • Medicaid providers’ obligation to maintain books and records and to be subject to OMIG’s audits
  • Detail on the audit process used by OMIG
  • OMIG’s objective when conducting audits
  • Detail on the various stages of the audit process:
  • Phase 1: Planning
  • Phase 2: Field work and analysis
  • Phase 3: Reporting
  • Provider recommendations – recommendations by OMIG to ease the audit process.

Harris Beach has extensive experience representing providers during the audit process, specifically in the reporting phase when OMIG identifies an overpayment and seeks a recovery and/or imposes sanctions, interest, and penalties. Additionally, Harris Beach assists providers in conducting a self-disclosure when providers self-identify an overpayment, and in responding to audit and recovery demands from the Medicaid Fraud Control Unit (“MFCU”) and the HHS Office of Inspector General (“OIG”).

Please contact Matthew Babcock at mbabcock@harrisbeach.com if you would like to engage Harris Beach to provide any additional information on OMIG’s audit process, or to assist during or following an audit by OMIG, MFCU or OIG.

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.