New York State Office of the

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OMIG Webinar 22 "The OMIG Exclusion and Reinstatement Process" is now posted. Please click this link to access the recording of the webinar. If you have questions regarding the webinar, please email them to information@omig.ny.gov and we will collect them and post a frequently asked questions document.
Dr. Andrew Russo became the subject of a claims review after potential billing irregularities were identified. Before a full medical review could be initiated, however, Russo stopped billing Medicaid, and in October 2013 he allowed the registration on his medical license to lapse. OMIG investigators researched Russo’s inactivity, only to discover that he had been arrested and charged with a Class C Felony for the Criminal Sale of a Prescription Controlled Substance. On June 26, 2013, Russo pleaded guilty to the charges and was sentenced to five years of probation. OMIG prepared a Notice of Immediate Agency Action (NOIAA) to exclude Dr. Russo from the Medicaid program.

The Affordable Care Act requires Medicaid providers to "self-disclose" - to report and return any dollars that the provider should not have received. In order to aid providers in this process, on August 6th, 2014 the Office of the Medicaid Inspector General (OMIG) hosted a webinar that shows Medicaid providers in New York how to self disclose. Self disclosure efforts by OMIG and providers yielded over $20 million in returned payments during OMIG's last reporting year. OMIG suggests that every Medicaid provider view Webinar #21 - Self Disclosure to understand how the process works, and what they can do as a provider to comply with this important requirement.

The Office of the Medicaid Inspector General (OMIG) received a complaint in September 2011 alleging that Licensed Practical Nurse Tammy Beth Wojtach was billing Medicaid for services not rendered. Her fraudulent billing was discovered after she left a position in which she cared for a 10-year-old recipient with cerebral palsy. When the new nurse submitted bills for the same recipient, the claims were denied by Medicaid because Wojtach had already used all of the approved hours from the patient’s Medicaid prior authorization. OMIG subsequently received additional information indicating that Wojtach was billing for services while she was on a cruise in the Caribbean. OMIG investigators obtained and analyzed relevant Medicaid data, conducted interviews, and referred the case to the Attorney General’s Medicaid Fraud Control Unit. On November 19, 2013, Wojtach was arrested by the New York State Attorney General’s Office. She was arraigned in Central Islip on a felony charge of third-degree grand larceny related to the matter OMIG had referred. On January 7, 2014, Wojtach pleaded guilty to the lesser offense Petit Larceny. She was sentenced on March 4 in Suffolk County to restitution of $18,299 and three years of probation. OMIG excluded Wojtach from the Medicaid program effective May 21, 2014.

OMIG published Compliance Guidance 2014 - 04 Revision # 1. This compliance guidance gives information relevant to inpatient chemical dependency rehabilitation and outpatient chemical dependency services providers. This document is part of a series of guidance documents that can be seen here.

Report Fraud

Report FraudYou can help stop Medicaid fraud: Call OMIG’s Fraud Hotline at 1-877-87 FRAUD (1-877-873-7283), or click here to file a complaint electronically.

Check for Terminations and Exclusions

Check for Medicaid Terminations and ExclusionsThe OMIG may sanction some providers by excluding them from participating in the Medicaid program. These providers are excluded from offering services to Medicaid enrollees and also cannot be paid with Medicaid dollars. Prior to adding new staff members, employers should check to see if prospective employees have been excluded from Medicaid. To make it easier to perform such a check, OMIG set up a dedicated service to check the status of any exclusion.

Latest News

OMIG Webinar 22 "The OMIG Exclusion and Reinstatement Process" is now posted. Please click this lin [ ... ]

Dr. Andrew Russo became the subject of a claims review after potential billing irregularities were i [ ... ]

The Office of the Medicaid Inspector General (OMIG) received a complaint in September 2011 alleging  [ ... ]

The Affordable Care Act requires Medicaid providers to "self-disclose" - to report and return any d [ ... ]

OMIG published Compliance Guidance 2014 - 04 Revision # 1. This compliance guidance gives informati [ ... ]

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Start a Self Disclosure

Start a Self DisclosureAnytime a health care organization discovers that it was paid more than it was due, this should be reported to OMIG. Our Self-Disclosure section provides information for health care organizations to complete the recently revamped self-disclosure process.

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