Federal authorities conducted coordinated law enforcement operations at adult day care facilities across New York City on October 20, 2026, as part of ongoing investigations into suspected Medicaid fraud. The operations involved facilities in Brooklyn, Queens, and Staten Island and have raised serious concerns among adult day care operators and other Medicaid-funded healthcare providers. According […]
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New York Medicaid Managed Care Audits: Why Providers Are Being Reviewed More Closely
A Medicaid managed care audit in New York may start with a health plan’s Special Investigation Unit, an outside audit vendor, or the New York State Office of the Medicaid Inspector General. The letter may ask for medical files, orders, service logs, billing support, employee information, or records tied to a defined group of claims. […]
OMIG Self-Disclosure in New York: When Should a Provider Consider It?
A billing error does not always arrive with an audit letter. It may surface during a routine claims review, an employee report, a software check, or a review of documentation that does not support what Medicaid paid. Once a New York provider identifies an improper Medicaid payment, the issue moves from an accounting concern to […]
What Happens When a New York Provider Gets an OMIG Education Letter?
An OMIG education letter can look less serious than an audit demand, but New York Medicaid providers should still take it seriously. The letter may not accuse the provider of fraud. It may not demand repayment right away. It may not ask for boxes of records by a strict deadline. Still, it can be an […]
Medicaid Billing for Deceased, Hospitalized, or Incarcerated Patients in New York
Medicaid billing fraud investigations in New York often begin with a simple question: could the patient have actually received the billed service on that date? For New York providers, billing companies, transportation companies, clinics, home care agencies, and other Medicaid participants, that question can turn into a serious problem when claims appear under the names […]
Medicaid Transportation Fraud New York: Why Transportation Companies Are Facing More Scrutiny
Medicaid transportation fraud investigations in New York have become a serious concern for ambulette companies, taxi providers, livery operators, dispatch services, and owners involved in non-emergency medical transportation. For many transportation companies, the business can look simple from the outside. A patient needs a ride to a medical appointment. A driver picks them up, takes […]
