OMIG Posts Assisted Living Program Audit Protocols

The New York State Office of the Medicaid Inspector General (OMIG) has released its final audit protocols for Assisted Living Programs (ALPs). These protocols became effective November 22, 2013 and are the OMIG’s audit tool that they will use when conducting their audits of ALPs.  The protocols contain 22 areas of potential disallowances based upon various documentation requirements and timelines.

The protocols explain what will constitute an error to the OMIG and lead to the OMIG attempting to recoup money previously paid for Medicaid claims.  These protocols provide the best source of information as to what the OMIG will be looking for during an ALP audit, as well as what criteria ALP providers should be auditing themselves against. 

This post was written by David R. Ross, Shareholder of O’Connell and Aronowitz. Mr. Ross presented, along with Medicaid Inspector General James Cox, on OMIG ALP audits at the NYSHFA/NYSCAL Fall Conference last year in Troy, New York.

Mr. Ross served as General Counsel and Director of Audits and Investigations at the OMIG and was also the Acting Medicaid Inspector General under Governors Pataki and Spitzer. Please contact Mr. Ross for more information at dross@oalaw.com