New York Medicaid Inspector General’s Office Posts Compliance Program FAQS

Harris Beach PLLC

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.

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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