New York Office of the Medicaid Inspector General · October 28, 2026 · Primary source
OMIG Posts Latest Audit Project Fact Sheets
Summary
The New York Office of the Medicaid Inspector General (OMIG) has posted new Audit Project Fact Sheets covering three completed audit projects: payments by Medicaid Managed Care Organizations to excluded providers from April 2017 through March 2021, OPWDD IRA Residential Habilitation services audited through June 2018, and 2024 capitation payments for incarcerated Medicaid enrollees. The fact sheets summarize audit purposes, number of audits conducted, results, and common findings. OMIG describes the initiative as a transparency and provider education tool highlighting compliance risks for providers regardless of whether they were individually audited.
What this may mean
New York Medicaid managed care organizations that made payments to excluded providers during the 2017 to 2021 period face documented audit findings and potential recoupment exposure. Separately, capitation payments made for enrollees who were incarcerated for entire payment months in 2024 are subject to audit and recovery. Providers of OPWDD IRA Residential Habilitation services from the 2016 to 2018 period are on notice of common findings that OMIG has identified as compliance risks.
Informational only. Not legal, medical, financial, or other professional advice. Always consult a qualified professional familiar with your specific facts before relying on any item.
Related items
- New York Office of the Medicaid Inspector General · October 8, 2026OMIG-assisted investigation leads to arrest of Queens pharmacy owner in alleged $31 million Medicaid fraud schemeScore 95
- New York Office of the Medicaid Inspector General · October 22, 2026Governor Hochul Announces Joint Effort to Protect Taxpayer Dollars and Crack Down on Fraud Within Social Adult Day Care ProgramScore 89
- New York Office of the Medicaid Inspector General · September 29, 2026OMIG-Assisted Investigation Leads to Arrest of Queens Dentist in Alleged $300,000 Medicaid Fraud SchemeScore 87
- State Legislation: Bill Amendments · October 26, 2026CA AB 1126: new version, 09/14/26 - ChapteredScore 85
- New York Office of the Medicaid Inspector General · September 29, 2026UPDATE: Two Capital Region Brothers Plead Guilty in $1.6 Million Medicaid Transportation Fraud SchemeScore 85
- Louisiana Medicaid · October 24, 2026Informational Bulletin 25-32Score 83