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Revised TBI Audit Protocols Posted

The state Office of the Medicaid Inspector General (OMIG) has posted revised (July 3, 2015) audit protocols for the Traumatic Brain Injury (TBI) program.

They are available at https://www.omig.ny.gov/images/stories/audit_protocols/tbi_protocol_7_3_2015.pdf.

The protocols cover: missing/incomplete service plan; missing documentation of service; billed more hours than authorized or documented; incorrect rate code billed; services performed by unqualified staff; staff training not completed; failure to meet health requirements; and other issues.

HCA members providing TBI services are strongly advised to review the revised audit protocols for compliance purposes.

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