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

OMIG Update: OMIG Posts Latest Audit Project Fact Sheets

OMIG has posted on its website the Audit Project Fact Sheets listed below.  Developed by OMIG’s Division of Medicaid Audit (DMA), the Audit Project Fact Sheet effort is an innovative reporting and communication initiative that serves 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.  The fact sheets 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 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.

Latest Audit Project Fact Sheet Postings:

Category: Provider Audit

Excluded Providers
Audits of Medicaid Managed Care Organizations (MMCOs) that made payments during the period April 1, 2017 – March 31, 2021, to providers that were excluded from participating in the NYS Medicaid program.
View the Fact Sheet

OPWDD IRA Residential Habilitation
Audits of OPWDD IRA Residential Habilitation services from January 1, 2016, through October 1, 2016, and an end date of June 30, 2018*.
*Note, the audited period pre-dates the "Transition to People First Care" beginning July 1, 2018, as outlined in OPWDD Administrative Directive 2018-ADM-06R2.
View the Fact Sheet

Category: Managed Care Audit

2024 Incarcerated Enrollee Match
Audits of Medicaid Managed Care capitation payments for enrollees who were incarcerated for the entirety of one or more payment months and were reported to OMIG in calendar year 2024.
View the fact sheet

OMIG Project Fact Sheets and additional information about this initiative can be found at: Audit Project Fact Sheets | Office of the Medicaid Inspector General