OMIG Compliance Plan Guidance

August 17, 2023

On April 6, the NYS Council met with lead representatives from the Office of the Medicaid Inspector General (OMIG) to discuss OMIG’s (new) Provider Compliance Plan Guidance.  Over one hundred NYS Council members attended the meeting and participated in this important discussion.  During the meeting, a member agency asked a question about voided claims and self-disclosure.  Meeting participants expressed concern that the process for making self-disclosures was not clear in the (new) OMIG Guidance document.  OMIG representatives stated they did not have an immediate answer/response, but they would take the question back for further review by their team and in the meantime, providers should continue to self-report in the same manner they had been prior to the release of the new guidance.   

The NYS Council followed up with lead representatives at OMIG numerous times, seeking the promised clarification.  Earlier this week, we met with the Governor’s Office requesting their assistance in getting a response from OMIG, and seeking assurances that providers would not be held responsible for the lack of clarity around self-disclosures of voided claims.

Yesterday we received word from the Governor’s Office that OMIG will issue updated guidance in the coming weeks, and that providers will ONLY be held to whatever the new standard/clarified standard is re: self-disclosures of voided claims going forward.  Put another way, OMIG agreed that it will only hold providers accountable to meet the new standard prospectively, and while we await the update, providers are in compliance by following the previous disclosure process.

At this juncture, we await the release of the updated Guidance from OMIG.  Stand by and thank you for entrusting the NYS Council to represent your interests!