On August 21, 2023, the New York State Office of the Medicaid Inspector General (OMIG) published an update to its self-disclosure program. The update allows for two (2) types of self-disclosures: (i) an Abbreviated Statement Self-Disclosure; and (ii) a Full Statement Self- Disclosure.

The Abbreviated Self-Disclosure process is aimed at addressing overpayments that result from routine transactional errors. This process requires the provider to complete and submit a Self-Disclosure Abbreviated Statement within 60 days of identification of an overpayment, or by the date any corresponding cost report was due, whichever is later. It is important to note that an Abbreviated Self-Disclosure is still required even when the error has been repaid through voids or adjustments.

The other type of OMIG self-disclosure that a provider can submit is a Self-Disclosure Full Statement. This disclosure process is also required within 60 days of identification of an overpayment, or by the date any corresponding cost report was due, whichever is later. That being said, this disclosure is aimed at addressing overpayments that result from more traditional self-disclosure issues such as: (a) errors that require a provider to implement a formal corrective action plan; (b) actual potential or credible allegations of fraudulent behaviors by employees; (c) systemic billing or claiming issues; (d) any error with substantial monetary or program impacts; and (e) non-claim based Medicaid overpayments.

The development of the Abbreviated Statement will likely result in a higher administrative burden for Medicaid providers. Historically, these more routine errors did not require formal reports. Although the Abbreviated Statement is a short form, it is likely that providers will have to implement a process to report these (in some cases) more frequent overpayments.

The updated Self-Disclosure Guidance is available here.