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New York State Office of the

Medicaid Inspector General


Fighting Fraud. Improving Integrity and Quality. Saving Taxpayer Dollars.


Compliance

The Bureau of Compliance works to educate, assist, and assess Medicaid program providers in meeting their obligation to establish and operate effective compliance programs that will prevent or, in the alternative, detect and address fraud, waste, and abusive practices within the Medicaid program. The effect of the Bureau's efforts is to encourage and work with providers to self-assess weaknesses in their participation in the Medicaid program to reduce Medicaid providers' fraud, waste, and abuse before the Medicaid program is billed and to ensure Medicaid providers have systems that will identify when errors are made so that corrections can be initiated and made by providers.



Compliance Certification

Certification is an annual requirement. Click here to see information about NYS Mandatory Provider Compliance Programs and Federal Deficit Reduction Act certification.

For additional information on compliance authorities and frequently asked questions, please see the Compliance Library.

Corporate Integrity Agreements

The purpose of a Corporate Integrity Agreement (CIA) is to promote adherence with the requirements of New York's medical assistance program ("Medicaid program") by the Medicaid provider and the provider's officers, directors, employees, and contractors. If a provider has committed some act that could have caused that provider to be excluded from the Medicaid program, the regulatory agencies through coordination with OMIG's Bureau of Compliance, may consider allowing the provider to remain in the Medicaid program on the condition that the provider enter into a CIA with OMIG and comply with the CIA's terms. The CIA's requirements serve to create a structure reinforcing operation by the provider at an acceptable standard. A material breach of the CIA could cause the provider to ultimately be excluded.

Contact Bureau of Compliance
 

If you have any questions related to the mandatory compliance requirements of the New York State Social Services Law Section 363-d; 18 New York Code of Rules and Regulations, Part 521; or the Federal Deficit Reduction Act of 2005 (DRA), you may contact 518.408.0401 or fill out the contact form below:

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NYS OMIG Compliance Library
Compliance Library