Documents from Step-by Step's case on file at the OMIG, which were released to Arkansas Business under the Freedom of Information Act, gives some insight into the extent of the alleged false and fraudulent billing that occurred at Step-byStep between Sept.
In November, Smith filed an appeal in Pulaski County Circuit Court and challenged OMIG's ruling that suspended Step-by-Step's Medicaid payments.
The Office of Medicaid Inspector General launched an investigation into Step-by-Step in June 2014 after the mother of a client called the OMIG's hotline.
The OMIG reviewed the medical records of 101 Step-byStep clients, records that originated between Sept.
"In addition, there were daily service logs suggesting delivery of services that were provided after the beneficiary had died," the OMIG report said.
"Step-by-Step alleged that [Kincade] was the only employee responsible for the fraud, but the evidence suggested that many other representatives for Step-by-Step were a part of and involved in the suspected fraud discovered by OMIG," Pickering wrote.
In contrast, the New York OMIG takes an alternative approach, providing a clear six-year "look-back" period with limited exceptions.
This ambiguity contrasts with the explicit statement of the New York OMIG that a disclosure will be taken as evidence that the provider's compliance plan is effective.
The simplest improvement CMS could make to the SRDP is to make the kinds of statements about the SRDP that the OIG and New York OMIG have made about their protocols.
(230) Sheehan & Hussar, supra note 19, at 31 ("OMIG will not require or expect providers to look-back more than six years from the date of disclosure unless the disclosure involves a base year cost report, or OMIG determines that there is a basis to suspect fraud.").
The OMIG also has space at 90 Church Street, a building owned by the large New York City landlord Boston Properties.
"We can't do anything until the budget is passed," said Wanda Fischer, a spokeswoman for the OMIG. "The landlord is well aware that as soon as the situation is cleared up, the rent will be paid in full."