senate Bill S2617A
(R, C, IP) 57th Senate District
- In Committee
- On Floor Calendar
- Passed Senate
- Passed Assembly
- Delivered to Governor
- Signed/Vetoed by Governor
Creates incentives for counties to investigate and prosecute medicaid fraud.
TITLE OF BILL: An act to amend the social services law, in relation
to creating incentives for counties to investigate and prosecute
PURPOSE: The purpose of this bill is to provide financial incentives
to the City of New York and the counties to identify and prosecute
Medicaid fraud, thereby helping eliminate fraud, waste and abuse.
SUMMARY OF PROVISIONS: The social services law is amended by adding a
new article 5-A and amending subdivision 2 of section 145-b to enable
the City of New York and the counties to keep 100% of the local share
of any successful Medicaid fraud prosecution or settlement, or 10% of
the total recovery, whichever is greater.
JUSTIFICATION: It is essential to minimize any waste, fraud or abuse
in the Medicaid system by encouraging and rewarding successful efforts
by the City of New York and the counties to prosecute Medicaid fraud.
The current law limits the amounts that local governments can receive
based on successful Medicaid fraud prosecution. This bill would ensure
that local governments would receive 100% of the local share of such
Medicaid payments, thereby reimbursing the local governments in full
for the original overpayment. Since the local share on some programs
may be very small, the local governments would be guaranteed at least
10% of any recovery, including settlement. The State would receive the
balance of recoveries.
By encouraging more Medicaid fraud prosecutions, the total costs of
the system will be reduced, to the benefit of both the State and local
governments. The State, of course, would be the biggest beneficiary of
the reduction in the amount of fraud and abuse because it pays a
substantially higher percentage of Medicaid costs than the local
This legislation is particularly important because the existing
Medicaid payment cap that applies to local governments inadvertently
reduced the financial incentive for local governments to root out
fraud, waste and abuse. Under the cap legislation, the cost to local
governments is automatically determined by the amount specified by the
cap rather than being based on actual costs. This bill would restore
the financial incentive to local governments by enabling them to enjoy
100% of the local share of any savings resulting from successful
Medicaid fraud prosecutions and settlements.
LEGISLATIVE HISTORY: 2012: S 6881/A.9494 Passed Senate
FISCAL IMPLICATIONS: This bill allows the city of New York and the
counties to recoup 100% of the local share upon the successful
prosecution or settlement of Medicaid fraud, or 10% of the total
recovery, whichever is greater.
EFFECTIVE DATE: This act shall take effect immediately.
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