January 27, 2024
The NYS Council continues to lead a statewide effort to ensure passage of meaningful OMIG Audit Reform legislation. I’m pleased to report we have Assembly and Senate ‘same as’ bills in the Legislature, S.5329-B (Harckham)/A.6813-A (Paulin) and we are again working with a large group of associations and coalitions that represent Medicaid healthcare providers/agencies from across the healthcare continuum of care.
Yesterday, Assembly Health Chair (and bill sponsor) Amy Paulin circulated a Memo to her Assembly colleagues asking for their support of the Assembly version of the bill (see below).
1) On Monday, please make a call to your Assembly representative and request that he sign on as a co-sponsor of Assembly bill (see yellow highlight below) A. 6813-A. When you call, tell the person you spoke with that you will follow-up with them in a few days to ensure the lawmaker took action and signed on.
2) Use this link: https://cpstate.org/advocacy/ to create a letter you can send to your lawmaker using the CPNYS Letter Generator. (Note: Currently, the link takes you to a page on the CPNYS Website where you will see the primary budget requests for our colleagues who represent OPWDD providers/agencies that are a bit different from MH and SUD requests. Don’t be confused! Just scroll down to the box that talks about OMIG Reform. The letter you send will be from you – not CPNYS or any other entity.
From: “Amy R. Paulin” <email@example.com>
Date: January 26, 2024 at 1:24:42 PM EST
To: firstname.lastname@example.org, email@example.com
Cc: Rachel Morris <firstname.lastname@example.org>
Subject: Circulation Memo for Sponsorship of Legislation to Reform Office of the Medicaid Inspector General Audits
To: Assembly Colleagues
From: Amy R. Paulin
Re: Sponsorship of legislation to reform Office of the Medicaid Inspector General Audits
Date: January 26, 2024
I have introduced A.6813A to provide additional due process protections to health care providers and recipients in the medical assistance program when under scrutiny by the Office of the Medicaid Inspector General (OMIG).
When the OMIG was created in 2007, the emphasis of the legislature and the concern of the public was on fraud and waste in the Medicaid system. Experience with the law has made it clear that the current statute is missing key provisions necessary to assure fairness and procedural clarity for all the parties involved.
OMIG audits that punish providers for technical errors, not fraud, do not help anyone in the Medicaid system, especially when those errors are the result of contradictory guidance provided by different state agencies. Further, the OMIG’s practice of extrapolating millions of dollars of claims from a small sample of technical errors has been forcing some already fiscally perilous health care providers to close, which ultimately harms patients.
This bill would introduce several common-sense provisions into the OMIG audit process, like enhancements that define overpayments and the circumstances that would not apply, expanded provider rights for the correction of technical errors and timeframes involved, and limits on extrapolation consistent with CMS standards used for federal audits.
If you would like to sponsor this legislation, please email Rachel Morris at email@example.com and indicate whether you wish to be a co- or multi- sponsor by Monday February 12th.