Covered by NYDaily News. Las Vegas man accused of threatening a prominent attorney and making vile remarks.
Covered by New York Times, and other outlets. Fake heiress accused of conning the city’s wealthy, and has an HBO special being made about her.
Accused of stalking Alec Baldwin. The case garnered nationwide attention, with USAToday, NYPost, and other media outlets following it closely.
Juror who prompted calls for new Ghislaine Maxwell trial turns to lawyer who defended Anna Sorokin.
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Last Updated on: 13th October 2023, 01:54 pm
OMIG was actually established in New York Public Health Law, specifically Title 3 of Article 1. So they are enabled by state law to carry out their duties related to Medicaid oversight.
Some of OMIG’s main responsibilities include:
OMIG conducts routine audits and inspections of Medicaid providers across New York. Some of the common issues they investigate include:
If OMIG identifies potential fraud or abuse, they have the authority to recoup Medicaid funds through various methods, like payment suspensions, pre-payment reviews, and more.
Sometimes providers or facilities will uncover billing issues or overpayments themselves. In these cases, they may want to self-disclose to OMIG before an audit or investigation begins.
Self-disclosures can show OMIG that the provider is being proactive. OMIG recently updated the self-disclosure process, giving providers two options:
Experienced OMIG lawyers can help providers through this process, including calculating the overpayment amount accurately.
Certain Medicaid providers in New York are actually required to have compliance programs in place under state law and regulations. These help prevent, detect, and correct fraud, waste, and abuse.
OMIG recently overhauled the rules related to mandatory compliance programs. Some key changes include:
An experienced OMIG attorney can help providers implement and maintain an effective compliance program that meets all of OMIG’s requirements.
If OMIG takes an enforcement action, like imposing penalties or suspending payments, the provider has the right to appeal. There is an established appeals process that involves administrative hearings.
Some key things to know:
Having an experienced OMIG attorney represent you during the appeals process is extremely valuable, as they understand the procedures and can build the strongest case.
In some serious fraud cases, OMIG may refer the matter to prosecutors for potential criminal charges. This can lead to felony Medicaid fraud charges.
If facing criminal prosecution, having an OMIG lawyer who also does criminal defense work is key. They can advocate during the investigation stage to avoid charges and negotiate with prosecutors. If charges are filed, they can defend at trial or negotiate a favorable plea deal.
Here are some quick tips for healthcare providers and facilities in New York when it comes to OMIG:
Don’t hesitate to ask candidates about their specific OMIG experience! This is a niche area, so you want someone who knows the ins and outs.
I hope this overview gives you a good sense of what an OMIG investigation involves and why working with an experienced OMIG lawyer is so important. Let me know if you have any other questions!
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