Manatt Health Partner Randi Seigel spoke with Crain’s New York Business on how Medicaid managed care plans may be affected by a proposed rule issued by New York’s Office of the Medicaid Inspector General requiring more intensive investigations into fraud and abuse.
In the article, Seigel explained that the provisions would require plans and Medicaid-enrolled providers to hire a significant amount of compliance professionals. “It's very hard to hire a compliance professional or a fraud, waste and abuse investigator,” Seigel said. “There’s a much higher demand for the job than there are individuals who are qualified or interested.” The rules would also add compliance-related documentation requirements, as well as increase the threshold for providers required to adopt a compliance program. “The proposed rules are making sure your compliance program isn’t just on paper and that you’re actually implementing and evaluating the program as a whole,” Seigel concluded.
Read the full article here.