In an attempt to go after No-Fault Insurance Fraud, New York State and Gov. Andrew Cuomo are seeking to expand current regulations regarding the information that physicians and clinics are required to provide. The expansion would include provisions that will bar suspected providers from participating in, and billing for, services under the No-Fault regulations of New York State.
According to a non-public “list” of suspected providers held by the office of Governor Cuomo, over 100 providers have been initially targeted. Letters are being sent to providers demanding certain information in connection with the investigation. The State has made it clear that such information can be turned over to the Department of Health (OPMC – Office of Professional Medical Conduct) and the Education Department (OPD – Office of Professional Discipline) for the purpose of bringing potential professional misconduct allegations against any physicians and other providers, whom they consider to be engaged in fraudulent activities for action to be taken against their license. Such information might also be shared with other government enforcement agencies.
Providers need to be aware of their rights, and what they are required to do and provide in light of the regulations, should they receive such letters. In many cases, proper planning to make sure that a practice complies with relevant laws and regulations is important prior to any investigation.