F/U on OPRA Audits

January 15, 2021

Yesterday evening we learned that initially, OMIG targeted a much larger group of providers (382 providers to be precise) for its’ OPRA audit, all with the same criteria as the 32 providers that are currently under audit.

Ultimately, OMIG decided to begin by conducting a much smaller ‘probe’ of 32 providers, to see what the results would be, how providers would respond in terms of appeals or acceptance of the findings, etc.  This is why it is so critical for the 32 impacted providers to respond with strong arguments.  This afternoon OMH and OASAS are co-hosting a call for the 32 impacted providers.  I will let you know what I learn from that call.

Note:  According to OMH, CCBHC Demo providers are not included in the larger audit (mentioned above).  Apparently OMIG has pulled data by rate code and included clinic FQHCs and clinic APG rate codes only.   As we said yesterday after the call, and based on our most recent intelligence from Bob Hussar, there is a high probability the audits will broaden, roll out very soon and that they could ultimately extend across the healthcare system.