News & Analysis as of

New York Medicaid Health Care Providers

Rivkin Radler LLP

NY Medical Transport Owner Sentenced for Medicaid Fraud

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The owner of Sublime Medical Transportation in Schenectady County, New York was recently sentenced to three to nine years in state prison for orchestrating a large Medicaid fraud scheme. Muhammed Adnan Saeed netted over...more

Sheppard Mullin Richter & Hampton LLP

Policy Brief: Aligning Nursing Home Bed Planning with New York’s Certificate of Need Reform Goals

Last month, New York State began a formal review of its Certificate of Need (CON) process for nursing homes, launching a timely conversation about how best to align regulatory oversight with evolving system needs. A new...more

Sheppard Mullin Richter & Hampton LLP

Understanding the Federal Reconciliation Bill’s Implications for MCO Tax Structure

New York’s Medicaid financing strategy—particularly its use of a managed care organization (MCO) tax—has come under renewed federal scrutiny amid recent legislative proposals and regulatory developments. The federal...more

Littler

New York Court Issues Decision and Order Declaring the DOH’s August 2024 Reimbursement Rate Adjustment for Fiscal Intermediaries...

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On March 20, 2025, a New York Supreme Court Justice in Albany County issued a decision and order declaring the New York State Department of Health (NY DOH)’s August 2024 implementation of an administrative rate reimbursement...more

Rivkin Radler LLP

The Status of Providing Gender-Affirming Care to Minors in NY

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In recent months, Executive Orders issued by the current Administration regarding gender-affirming care of minors have been the subject of much debate and litigation. The crux of these lawsuits is largely two Executive...more

McDermott Will & Schulte

New York Executive Budget Proposes Amendments to MCO Provider Tax

The New York State Executive Budget for Fiscal Year (FY) 2026 proposes significant updates to the managed care organization (MCO) provider tax, aiming to enhance Medicaid funding through innovative financial strategies. The...more

McDermott+

Policy Update - New York 1115 Waiver Amendment Timeline for Medicaid Hospital Global Budget Initiative

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A key element of the Medicaid Redesign Team 1115 Waiver amendment is the Medicaid Hospital Global Budget Initiative (GBI), a reimbursement model tied very closely to the States Advancing All-Payer Health Equity Approaches and...more

Epstein Becker & Green

An Overview of the CMS Approved New York 1115 Medicaid Waiver

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On January 9, 2024, the Center for Medicare and Medicaid Services (CMS) sent a letter to New York’s Medicaid director approving New York’s Section 1115 Waiver amendment, which the state submitted for approval on September 2,...more

Robinson & Cole LLP

Health Law Diagnosis - New York OMIG Issues 2022 Annual Report

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On Monday, October 2, 2023, the New York Office of the Medicaid Inspector General (OMIG) published its Annual Report for 2022. The Report details the various efforts that New York’s Medicaid program undertook in 2022 to...more

Robinson+Cole Health Law Diagnosis

New York OMIG Issues 2022 Annual Report

On Monday, October 2, 2023, the New York Office of the Medicaid Inspector General (OMIG) published its Annual Report for 2022. The Report details the various efforts that New York’s Medicaid program undertook in 2022 to...more

Littler

New York Department of Health Sets New Due Dates for Submission of Home Care Worker Wage Parity Compliance Certifications and...

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On September 21, 2023, the New York Department of Health (DOH) issued guidance addressing the due dates for Medicaid Managed Care Organizations (MMCOs), Certified Home Health Agencies (CHHAs), Licensed Home Care Services...more

Harris Beach Murtha PLLC

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

Mintz - Health Care Viewpoints

New York’s Office of the Medicaid Inspector General Creates Abbreviated Self-Disclosure Process

On August 21, 2023, the New York State Office of the Medicaid Inspector General (OMIG) issued updated guidance regarding its Self-Disclosure Program (Updated Guidance). In the final days of 2022, New York’s Department of...more

Robinson+Cole Health Law Diagnosis

Two Pathways for Medicaid Self-Disclosures Announced by OMIG

The New York Office of the Medicaid Inspector General (OMIG) recently announced updates to its Self-Disclosure Program in response to feedback from Medicaid stakeholders after its revised posting in January 2023. OMIG revised...more

Harris Beach Murtha PLLC

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

Harris Beach Murtha PLLC

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

Sheppard Mullin Richter & Hampton LLP

Attention New York Medicaid Providers: It’s Time to Upgrade Your Compliance Program

On January 31, 2023, the New York State Office of the Medicaid Inspector General (OMIG) released three guidance documents to assist Medicaid providers in meeting the requirements of recently adopted regulations governing (i)...more

Rivkin Radler LLP

OMIG Update: Compliance, Self-Disclosure, and Managed Care Fraud, Waste and Abuse Guidance Posted

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On the heels of publishing their final regulations, on January 31, the New York Office of the Medicaid Inspector General (OMIG) released a variety of guidance documents addressing compliance programs; self-disclosure; and...more

Rivkin Radler LLP

[Webinar] Lunch and Learn Series: OMIG's FINALIZED Regulations: What You Need to Do - NOW! - February 9th, 12:00 pm - 1:00 pm ET

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Please join us on February 9 as Partner Bob Hussar and Associates Ashley Algazi and Mary Connolly present on OMIG’s finalized regulations. On December 28th, the Office of Medicaid Inspector General (OMIG) released their...more

Littler

New York Department of Health Extends Deadline and Issues Additional Guidance for Health Care Worker Bonus Program

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In early August, the New York State Department of Health (DOH) announced and opened the New York Health Care Worker Bonus (HWB) Program, which provides $1.2 billion dollars in health care worker bonuses to eligible employees....more

Rivkin Radler LLP

[Webinar] Lunch & Learn Series: New OMIG Compliance Regulations: What You Need to Know - July 28th, 12:00 pm - 1:00 pm ET

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On July 13, the Office of Medicaid Inspector General (OMIG) published proposed regulations implementing 2020 changes to law relating to provider compliance programs, Medicaid managed care fraud, waste and abuse prevention...more

Rivkin Radler LLP

[Webinar] Lunch & Learn Series: New OMIG Compliance Regulations: What You Need to Know - July 27th, 12:00 pm - 1:00 pm ET

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On July 13, the Office of Medicaid Inspector General (OMIG) published proposed regulations implementing 2020 changes to law relating to provider compliance programs, Medicaid managed care fraud, waste and abuse prevention...more

Harris Beach Murtha PLLC

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

White and Williams LLP

Are Telehealth Laws Here to Stay? A Survey of Legislation in NJ, DE, NY, PA and MA

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As COVID-19 vaccines continue to roll out across the county, there is uncertainty as to whether certain telehealth laws that significantly impacted healthcare providers, payors and patients during the public health emergency...more

Seyfarth Shaw LLP

Seyfarth Policy Matters Newsletter - April 2020 #3

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Congress Replenishes Paycheck Protection Program (PPP) Through its Phase Four Coronavirus Relief Package. On Tuesday, via unanimous consent, the Senate passed the Paycheck Protection Program Increase Act of 2020...more

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