Deep Dive: Office of the New York State Medicaid Inspector General to Review Audit Protocols

May 8, 2025

By: Roger Bearden, Kaydeen M. Maitland, and Gabriel S. Oberfield, Esq., M.S.J.

The New York State Office of the Medicaid Inspector General (OMIG) issued numerous audit protocols, which it provides for healthcare delivery organizations seeking to satisfy the OMIG's operational and procedural expectations within New York State's Medicaid program. As an example, the OMIG issued protocols on March 6, 2025, for agencies receiving Medicaid reimbursement via Medicaid-funded contracts with the State's Office of Mental Health (OMH) and focused on Outpatient Treatment and Rehabilitative Services. 

Please join us as Michael D'Allaird, OMIG's Deputy Medicaid Inspector General for Audit, provides an overview of  audit protocols including how stakeholder input informs their development. Joining him will be Charles (Charlie) Falkner, Bureau Director Managed Care Network Provider & Fee-For-Service Review, who plays a key role in OMIG’s protocol efforts. 

This complimentary program, the eighth in an ongoing multi-part series, will be introduced by Bond attorney Kaydeen Maitland. Bond attorneys Roger Bearden and Gabriel S Oberfield will moderate a discussion concerning the OMIG’s presentation together with William Schwarz, who leads the OMIG’s office of public affairs.

Click here to view the presentation.

Part One: On September 27, 2023, Bond and the OMIG covered the OMIG’s release of an abbreviated process for self-disclosure concerning routine or transactional errors. A recording of the September program is available here. 

Part Two: On November 16, 2023, Bond and the OMIG covered global updates on the implementation of OMIG’s updated compliance standards. A recording of the November program is available here. 

Part Three: On January 31, 2024 the OMIG rovided medical provider compliance officers, administrators and executive officers with global updates on the implementation of OMIG’s updated compliance standards, with specific attention paid to a) compliance program training, as well as b) implementing effective lines of communication to compliance officers. The January program is available here.

Part Four: On June 5, 2024, Bond and the OMIG provided compliance officers, administrators and executive officers in healthcare with global updates on the implementation of OMIG’s updated compliance standards. The June program is available here. 

Part Five: On September 25, 2024, Bond and the OMIG discussed the roles and responsibilities in protecting New York State's Medicaid program, including in the conducting of audits, investigations, the recovery of overpayments, and in recommending managed care contractual and other program integrity requirements. The September program is available here. 

Part Six: On December 11, 2024, Bond and the OMIG provided compliance officers, administrators and executive officers in healthcare with an overview of the agency’s audit process as well as guidance on best practices both to prepare for and respond to OMIG audit inquiries. In the forthcoming program, speakers will highlight lessons learned and trends identified following OMIG’s review of programs. The December program is available here. 

Part Seven: On Febuary 26th, Erin Ives, OMIG's First Deputy Medicaid Inspector General, provided an overview of the 2025 Work Plan and shared keen insights into the agency's objectives as they relate to Medicaid providers and participants across New York State. The February program is available here.