Grassi Healthcare | EAlert: OMIG to Target Managed Care Services – How do you look?
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Healthcare Leadership Team

EAlert: OMIG to Target Managed Care Services – How do you look?

As Medicaid providers you are aware that NYS OMIG has altered their Work Plan from an annually published plan to a dynamic or rolling plan—which is adjusted throughout the fiscal year to adapt to the changing healthcare demands. This week OMIG announced several new initiatives, but the one that caught our eye is that which will target Managed Care Network Providers.

The OMIG Network Provider Review Project Team will perform audits of MCO participating providers to validate the accuracy of the claims and verify that encounter documentation and claim records are within both regulatory and contractual compliance. This initiative will be a collaboration between the MCO’s and the OMIG SIU (Special Investigation Unit). There will be a particular focus with respect to capitation payments.

Are you ready? Be proactive and be sure. Grassi Healthcare Advisors is ready to help you prepare for scrutiny should it arise. We have consultants experienced in service documentation, chart audit and litigation activities related to both state and federal reviews.