James Sheehan who heads up the Office of the Medicaid Inspector General (OMIG) reportedly has been asked to leave his position within 30 days.  Rumors of the move began spreading among healthcare and human service advocates yesterday.

“Jim Sheehan has been given a 30-day notice to get a new job,” wrote Jeffrey J. Sherrin of the law firm O’Connell and Aronowitz in an email which was distributed via the OMIG Advocacy Work Group list serve yesterday.

“It’s true,” one advocacy group leader said this morning.  “I’ve just gotten confirmation from a very reliable source.”

The OMIG’s office itself declined to comment, referring all questions to the Governor’s press office.  NYNP has been unable to obtain a comment from the Governor’s press office.

The OMIG’s extremely aggressive approach to audits of Medicaid providers and policies regarding recoupments which been a source of near terror for nonprofit providers.

“It is difficult to convery the level of anxiety and outright fear with which nonprofit service providers view OMIG,” NYNP wrote in our December 2009 cover story entitled The OMIG Who Stole Xmas.  “Providers now believe that everything – every clerical error, administrative oversight, missing signature, incorrect date, paperwork omission or late billing – is being considered by OMIG to be abuse at best and possibly even fraud at worst.  And, OMIG is coming to find them, multiply them by a factor of 100 or 200, and demand repayment.”   Providers argued at the time that the OMIG’s policies were driven at least to some degree by the Office’s extremely high budget target for audit recoupments – beginning with $215 million in 2008 and rising to $644 million in 2011 -- under a deal with the Federal government.  Subsequent State budget actions increased the OMIG’s target for audit recoupment even further. 

“This is a response from the administration to an unyielding and absolutely universal sentiment among providers that the OMIG hasn’t been playing fair, that there are difference between human error and fraud that was not recognized in the audit process.  The audits and the recoupments were tearing provider agencies apart,” said one nonprofit executive.

Comments

Liam Notlob

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I have worked with the Developmentally Disabled for over 30 years, and OMIG has done nothing short of terrorize the not for profit world providing services to those that need us the most Fraud and human error are not the same.........................................
unless you are OMIG!!

Wednesday 22 June 2011, 17:38

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Cynthia Rudder, Director Special Projects, LTCCC

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It is a tragedy for New York State that James Sheehan has been asked to leave. As advocates for long term care consumers, we were thrilled when Mr. Sheehan agreed to come to New York. His reputation of fairness and concern for quality care proceeded him. He has been a wonderful Medicaid Inspector General, encouraging his staff to consider poor quality as Medicaid fraud, which it is. This was, once again, a win for providers, a loss for consumers.

Friday 17 June 2011, 14:23

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IRA B.GOLDBERG

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THE PENDULUM NEEDS TO SWING BACK!!

Friday 17 June 2011, 09:12

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