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History
- Notice of committee consideration - withdrawn
- Notice of committee consideration - requested
- Referred to health
- Print number 4218a
- Amend (t) and recommit to health
- Referred to health
Companion bill
The same bill in the other chamber. A bill becomes law when one version passes both houses and the governor signs it, so either number can carry it.
Limits the withholding of payment to a medical assistance program provider subject to a pending audit
In Assembly Committee · Codes · Sponsor Robin Schimminger
Full text
The text isn't available here yet. Check nysenate.gov.
Sponsor's memo
Title of bill
An act to amend the public health law, in relation to limiting the withholding of payment to a medical assistance program provider subject to a pending audit
Purpose of the bill
This bill provides limitations on the withholding of Medicaid payments based on preliminary findings of a pending audit.
Summary of specific provisions
Section 1 amends Article 1, Title III of the Public Health Law by adding a new § 32-A related to auditing standards and procedures of the Office of the Medicaid Inspector General. The new §32-a prohibits withholding of Medicaid provider payments pursuant to preliminary findings of a pending audit unless the OMIG has made a written finding, based on probable cause, that the provider committed fraud or other criminal conduct involving the claims subject to the audit.
Section 2 sets forth the effective date.
Justification
In recent months, Medicaid providers have been the subject of intense audits by the office of the Medicaid Inspector General (OMIG) and contingency-based auditing firms at the state and county levels for administrative or clerical errors which, through the use of extrapolation, have resulted in exorbitant fines and payment recoupments per individual audit.
While the OMIG's efforts to identify and punish real Medicaid provider fraud and abuse are very important, some providers are being targeted by the OMIG for clerical mistakes, errors or misinterpretations that in no way constitute fraud and abuse.
The bill places limitations on the withholding of provider payments based on the preliminary findings of a pending audit unless there is a written finding, based on probable cause of fraud or criminal conduct.
Prior legislative history
2007-2008: A.10333.
Fiscal implications
None.
Effective date
Immediately, application to withholding of payment in effect on or commencing after the effective date.
Summaries, headlines and scores are AI-generated from the official bill text. How we score bills. Source: NYS Open Legislation.