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NYS DOH Seeks Grant Applications for Health Equity Social Care Networks

The New York Department of Health (DOH) recently announced it is accepting applications for New York Health Equity Reform: Social Care Networks regional grants. The nine regional grants will distribute a total of $500 million...more

NYS DOH Requests Applications for Health Care Facility Transformation Program

The New York Department of Health (DOH) recently announced it is accepting applications for the Statewide Health Care Facility Transformation Program IV. The grants will distribute $250 million to support capital projects and...more

New York OMIG Posts 2024 Work Plan

On January 3, 2024, the New York State Office of the Medicaid Inspector General (“OMIG”) posted its 2024 Work Plan. This is the first update since its 2019 – 2020 Work Plan and OMIG notes that the Work Plan does not reflect...more

New York DOH Revises Medical Respite Program Operator Rules

The New York Department of Health (DOH) is seeking public comment on its revised rulemaking that seeks to establish procedures for review and approval of applications from not-for-profit corporations to be certified as a...more

OMIG Stakeholder Engagement Session – Save the Date 11/30/2023

The New York State Office of the Medicaid Inspector General (“OMIG”) announced it will host an online engagement session on Nov. 30, 2023, to share feedback received during the April and May 2023 Provider Engagement Forums....more

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

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...more

9/29/2023  /  Compliance , Medicaid , New York , OIG , Penalties

Updated Medicaid Utilization Review Regulations from NYS Department of Health

The New York Department of Health (DOH) adopted regulations effective on September 13, 2023, that revised Medicaid Utilization Review for Medicaid fee-for-service benefits. The regulations were initially published on April...more

NYS Office of Medicaid Inspector General Updates Self-Disclosure Process

On August 21, 2023, the New York State Office of the Medicaid Inspector General (“OMIG”) updated its Medicaid Self-Disclosure Program Requirements. The updated Instructions and Guidelines announce a new “Abbreviated”...more

Updates Coming to OIG Compliance Program Guidance

The Department of Health and Human Services’ Office of Inspector General (“OIG”) willmodernize its Compliance Program Guidance (“CPG”) beginning at the end of calendar year 2023. The updates will be posted on the OIG website...more

Public Health Emergency Ends: Guidance from New York’s Office of Mental Health

The COVID-19 Federal Public Health Emergency (“PHE”) is scheduled to end on May 11, 2023. With the end of the PHE, a number of the federal and New York state agencies’ regulatory flexibilities put into effect during the PHE...more

Public Health Emergency Ends: Guidance from New York’s Office of People with Developmental Disabilities

The COVID-19 Federal Public Health Emergency (“PHE”) is scheduled to end on May 11, 2023. With the end of the PHE, a number of the federal and New York state agencies’ regulatory flexibilities put into effect during the PHE...more

New York Medicaid Fraud, Waste and Abuse Engagement Sessions Announced

The New York State Office of the Medicaid Inspector General (“OMIG”) announced March 30 it will host provider engagement forums in Albany, Rochester and New York City seeking comments and recommendations from health care...more

NY Department of Health Information for Pharmacies Submitting Medicaid 340B Drug Claims

On April 1, 2023, Medicaid members enrolled in mainstream Managed Care (MC) plans, Health and Recovery Plans (HARPs) and HIV-Special Needs Plans (SNPs) began receiving pharmacy benefits from NYRx, the pharmacy program under...more

New York Medicaid Office Issues New Compliance Program Information

On March 8, 2023, the New York State Office of the Medicaid Inspector General (“OMIG”) posted on its website a Compliance Program Review Module and a webinar that outlines the Compliance Program requirements for 2023 based...more

3/14/2023  /  Compliance , Medicaid , New York , OMIG

New York Issues Technical Specifications Manual that Addresses Medicaid Payment Reporting

The New York Department of Health (DOH) announced March 8 that the 2022-2023 Value Based Payment (VBP) Reporting Requirements Technical Specifications Manual is available....more

Expansion to New Employers and Employee Titles – Submission Period Announced

The New York Department of Health (DOH) announced on November 17 that the Healthcare Worker Bonus (HWB) Program will expand to include additional titles and eligible provider types. On January 13, DOH announced the opening...more

NY Medicaid Inspector General Finalizes Rulemaking for Medicaid Program Fraud, Waste and Abuse Prevention

On December 28, 2022, New York State Register published a summary of the New York State Office of the Medicaid Inspector General’s (“OMIG”) Notice of Adoption for Rulemaking on Medicaid Program Fraud, Waste and Abuse...more

Survey for Employers NOT Registered for the HWB Program – Survey Open Until Dec. 6

The New York Department of Health (DOH) announced November 30th it is releasing a survey for enrolled Medicaid providers who meet the eligibility criteria for the Healthcare Worker Bonus (HWB) Program, but are enrolled in...more

Healthcare Worker Bonus Program Notice of Expansion to New Employers and Employee Titles

The New York Department of Health (DOH) announced on November 17th that the Healthcare Worker Bonus (HWB) Program was being expanded to include additional titles and eligible provider types. For a list of the new qualified...more

Healthcare Worker Bonus Program Portal Opening Extended for Vesting Periods 1 & 2

The New York Department of Health (DOH) announced on October 31st it was extending the deadline for claim submissions on the Healthcare Worker Bonus (HWB) Portal until November 30. While DOH notes claims submitted after...more

Healthcare Worker Bonus Program Portal Open for Vesting Period 2

Vesting Period 2 covers the period April 1, 2022 through September 30, 2022. The New York State Department of Health opened the Healthcare Worker Bonus Program Portal to facilitate submissions by eligible employers on behalf...more

Leadership Change Noted in New York State's Medicaid Program

Earlier this month, the New York State Department of Health announced that Brett Friedman, who replaced Donna Frescatore in 2021 as the New York State Medicaid Director, is leaving the Medicaid Program. The Commissioner of...more

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