New York State Office of the Medicaid Inspector General (OMIG) Update

OMIG Launches Audit Project Fact Sheet Initiative

Effort serves to enhance transparency, reporting, and provider education

OMIG’s Division of Medicaid Audit (DMA) has commenced its Audit Project Fact Sheet effort, an innovative reporting and communication initiative that promises to bolster agency transparency, data and results reporting, and provider education.  Developed as a mechanism to highlight key audit project results, the fact sheets provide a brief overview of a completed audit project summarizing the purpose of the project, the number of audits conducted, the results of the audits completed, and the most common findings.  Going forward, the fact sheets will cover all DMA audit projects and provide specific project-level detail to supplement information contained in the agency’s annual report and work plan.  Additionally, the fact sheets will play a key provider-education role, including those organizations that did not receive an audit as part of the project, by highlighting potential compliance risks and areas on which to focus internal reviews.  DMA launched the effort by issuing the following fact sheets:

2018 Managed Care Program Integrity Reviews (MCPIR): Audits of Mainstream managed care plans for the 2018 calendar year of their compliance with program integrity obligations under their contract with the State.

2020 Public Assistance Reporting Information System (PARIS) Match: Audits of managed care plans for the 2020 calendar year of capitation payments paid for Medicaid beneficiaries living in another state.