OMIG Update

OMIG to Begin Performing a 12-Month Review Period for Compliance Program Reviews.

For reviews beginning after July 1, 2025, the New York State Office of the Medicaid Inspector General (OMIG) will use a 12-month review period for newly initiated Compliance Program Reviews (CPR). CPRs serve to determine whether required providers have adopted, implemented, and maintained an effective compliance program as required by Title 18 New York Codes, Rules, and Regulations Part 521. This change will not affect reviews currently being conducted by OMIG.

OMIG notifies required providers of its intent to commence a review of its compliance program by sending a written notification of the review period and procedures for completing the review. The required provider responds with a completed Module and related documentation within thirty (30) days. Providers will receive formal notification regarding the results of the review following OMIG’s completion of the review. OMIG will also engage and communicate with the provider throughout the course of review.

Additional information regarding the compliance program review process and provider requirements can be found on OMIG’s Compliance web page, located at: https://omig.ny.gov/compliance/compliance. Information regarding potential penalties for providers that do not have a satisfactory compliance program can be found on OMIG’s Compliance Library web page, located at: https://omig.ny.gov/compliance/compliance-library.

Questions regarding compliance program requirements should be directed to OMIG’s Bureau of Compliance by email at: compliance@omig.ny.gov.

NYSHFA | NYSCAL CONTACTS:

Lisa Volk, RN, B.P.S., LNHA
Executive Director, Foundation for Quality Care
518-462-4800 x15