Albany, NY – New York State Senator Pete Harckham and Assemblymember Amy Paulin, along with other legislators and behavioral health care, spoke in unison at a special press conference in the State Capitol today, calling for the FY2024-2025 State Budget to include a meaningful reform of current practices utilized by the NYS Office of the Medicaid Inspector General (OMIG) when it audits healthcare agencies that provide essential services to New Yorkers with Medicaid insurance.

A new OMIG reform bill (S.5329D / A.6813), introduced by Harckham and Paulin, seeks to rectify tactics used during Medicaid audits conducted by the OMIG that are needlessly punitive and, ultimately, ineffective in preventing fraud and abuse in the healthcare system. These audits take time and resources away from healthcare and mental hygiene agencies providing essential services to New Yorkers with Medicaid insurance.

“New York patients cannot afford to lose any more behavioral health providers, especially over unintentional administrative errors,” said Harckham. “The senseless undermining of Substance Use Disorder programs in the middle of an opioid epidemic needs to stop. Let’s not lose sight that these programs save lives, so regulatory efforts should be in line with supporting and improving services, not harming them.”

“The role of the NYS Office of the Medicaid Inspector General is to root out fraud and abuse,” said Paulin. “However, this should not mean that OMIG should have the ability to wipe out entire programs and services based on technical errors, state system issues, or minor discrepancies, especially when the service was delivered appropriately. This practice is crippling and risks the continued viability of New York’s safety net system. I urge the Legislature to include the provisions of our bill in the budget to protect our health care providers and safeguard OMIG’s role in ensuring Medicaid’s integrity.”

Current OMIG audit practices include application of extrapolation to clerical errors, which has resulted in disproportionate findings and enormous fines that can shut down an entire program or impact a Medicaid provider. This practice has been devastating to providers and risks the continued viability of New York’s safety net system. 

               Clerical errors result in care providers being punished and financially crippled.