NY Medicaid Inspector General Finalizes Rulemaking for Medicaid Program Fraud, Waste and Abuse Prevention

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On December 28, 2022, New York State Register published a summary of the New York State Office of the Medicaid Inspector General’s (“OMIG”) Notice of Adoption for Rulemaking on Medicaid Program Fraud, Waste and Abuse Prevention. This finalizes the Proposed Rulemaking that was published on July 13, 2022.

Although some changes were made to the regulatory language, OMIG characterizes those changes as “nonsubstantial.”

The full text of the Adopted Regulation is available here on OMIG’s website.

From this link, click on the blue Regulatory Activity heading. Under the Recently Adopted Regulations section, click on the blue Text of Rule and Statements for the full regulation or the blue Assessment of Public Comments for OMIG’s responses to the public’s comment on the July 2022 Proposed Rulemaking.

The Adopted Rulemaking would delete 18 New York Codes Rules and Regulations Part 521 in its entirety and replace it with a new Part 521. The organization of the new Part is as follows:

  • Part 521 Fraud, Waste and Abuse Prevention
  • Subpart 521-1 Compliance Programs
  • Subpart 521-2 Medicaid Managed Care Fraud, Waste and Abuse Prevention
  • Subpart 521-3 Self-Disclosure Program

DISCLAIMER: Because of the generality of this update, the information provided herein may not be applicable in all situations and should not be acted upon without specific legal advice based on particular situations.

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