This blog is devoted to current legal and regulatory issues affecting health care providers in New York, New Jersey and nationally. We regularly publish on topics of interest to doctors, pharmacists, hospital administrators, and everyone who is interested in the current developments in the legal landscape affecting health care delivery today.
We would like to remind all providers that, under current New York and Federal laws and regulations, they are obligated to report, explain and repay overpayments within calendar 60 days of identification. Those that fail to disclose, explain and repay the overpayment in a timely manner may be subject to liability under the New York and Federal False Claims Act.
Identifying and reporting compliance issues and refunding overpayments is also an essential component of a provider’s obligation to adopt and implement effective compliance programs that are mandatory in New York for certain Medicaid providers. In most circumstances, self-disclosure will result in a better outcome than if New York Office of Medicaid Inspector General ("OMIG") staff had discovered the matter independently. Potential benefits may include: