Medicaid Administrative Law Judges (ALJ) Decisions

This web page contains decisions by the New York State Department of Health (DOH) Administrative Law Judges (ALJ) in cases seeking recovery of overpayments from providers under the Medical Assistance Program (Medicaid). The Department conducts the hearings pursuant to Articles 1 and 5 of the New York Social Services Law (SSL) and Title 18 of the Official Codes, Rules and Regulations of the State of New York (NYCRR). The Department assumed responsibility for conducting the hearings in the late 1990s from the former Department of Social Services (DSS). Since 2006, the Office of the Medicaid Inspector General (OMIG) has represented the Medicaid Program in the hearings.

This web page contains all decisions that DOH issued in overpayment cases for years 2010-2012. New decisions, as issued, will be posted within thirty days from the date DOH serves the decisions on the parties. Past decisions, dating to the late 1970s, are available from DOH's Records Access Office. Also for the convenience of the public, this web page contains an index of decisions from 1977 to 2010. For anyone unable to download or read a document in the electronic format, DOH can provide a copy in an alternate format.

Please note that individual ALJ decisions may have been subject to subsequent judicial review which changed the outcome of the administrative decision.

Medicaid Decisions for Years 2010 - 2013

Medicaid Decision Index (1977 - 2010)