Important information re: recent OMIG Proposed Rule Making

July 15, 2022

This week, the Office of the Medicaid Inspector General (OMIG) published a Proposed Rule Making in the State Register related to Medicaid Program Fraud, Waste and Abuse Prevention with the stated purpose to establish requirements for providers to detect and prevent fraud, waste and abuse in the Medicaid Program.

RESOURCE:  To read a Manatt Health Highlights article that takes a closer look at some of the major elements of the proposed rule, use this link:

Public comments regarding the proposed Rule Making are due within 60 days from when published on July 13, 2022.

In particular, the proposed rule making would repeal and add a new 18 NYCRR Part 521 to implement statutory changes resulting from the recommendations of the Medicaid Redesign Team II as adopted in the State Fiscal Year 2020-2021 Enacted Budget (Chapter 56 of the Laws of 2020, Part QQ) and to make other conforming changes related to:

(1) Provider Compliance Programs, 

(2) Medicaid Managed Care Plan fraud, waste and abuse prevention programs under the Medical Assistance (Medicaid) program, and 

(3) The Obligation to report, return and explain Medicaid overpayments through OMIG’s Self-Disclosure Program.

To read the new sections added to OMIG regulation through this rule making in their entirety, please click here.