New York State County Medicaid Programs

Regulatory Compliance and Fraud Detection

To uncover Medicaid fraud or abuse, counties throughout New York State are turning to Bonadio to perform operational, policy compliance, billing and medical necessity audits of selected laboratories, pharmacies, transportation companies and physicians receiving reimbursement from their Medicaid programs. Bonadio has a well-qualified team of auditors, medical review staff, and investigators who have experience with Medicaid, compliance and claims auditing.

We are well equipped to audit a provider’s compliance with applicable Medicaid regulations and policies, acceptable billing practices, and principles of medical necessity. Bonadio is prepared to work with counties across New York State on the VERIFY New York program, as well as with other New York State Department of Health initiatives.

Bonadio is also well-versed and experienced in assisting counties in identifying instances of Medicaid fraud or abuse relative to self-employed individuals’ eligibility for Medicaid and/or temporary assistance.  In fact, we have more experience in Medicaid eligibility assessment and remediation than any other professional services organization in New York State.