Senator Flanagan Successful In Creation Of Medicaid Inspector General


In the continuing fight to protect the rights of New York taxpayers, legislation sponsored by Senator John Flanagan (2nd Senate District) to combat Medicaid fraud has been signed into law. This new law establishes the toughest, most comprehensive plan to combat Medicaid fraud in the United States and creates the new office of Medicaid Inspector General.

"Long Island taxpayers overwhelmingly want to be sure that their money is being used correctly and it is the state's responsibility to protect their investment. Medicaid is the single biggest portion of the state budget and, therefore, at the greatest risk of abuse. It is clear that there needs to be an effective mechanism in place to rid the system of fraud and the Medicaid Inspector General is that tool," stated Senator Flanagan.

Senator Flanagan has been a member of the New York State Senate Medicaid Reform Task Force since its inception in 2003. That task force has recommended several important measures that have become law, including the State cap on local Medicaid expenses and the State takeover of the local share of the Family Health Plus program, that have saved local property taxpayers billions of dollars. This new taxpayer protection was an idea that originated in that task force.

The new law will address the recommendations of the task force by:
-Creating a new, independent Office of Medicaid Inspector General by consolidating responsibilities and staff from six agencies into the new Office and empowering the Medicaid Inspector General with the ability to detect, investigate and recover improper Medicaid payments;

-Providing county governments with new incentives and access to information to become active partners in the fight against Medicaid fraud;

-Enhancing the capacity of the Department of Health and Office of Medicaid Inspector General to fight fraud with new, state-of-the-art technology;

-Establishing new protocols and procedures to ensure the effective sharing of information and evidence regarding Medicaid fraud between the Office of Medicaid Inspector General, the Attorney General’s Medicaid Fraud Control Unit, county governments and district attorneys;

-Requiring health care institutions to implement corporate compliance programs and allowing providers to request advisory opinions to ensure proper billing practices; and

-Creating new Health Care Fraud offenses to aid in the criminal prosecution of Medicaid fraud.

The new effort to rein in Medicaid fraud is the product of an agreement by a joint legislative conference committee comprised of members of both houses of the Legislature. It is designed to fight fraud and abuse at every step of the process, from billing and prepayment review to investigation, civil recovery and criminal prosecution of Medicaid thieves.

The federal General Accounting Office estimates that 10 percent of Medicaid expenses are diverted through fraud, an amount equal to billions of dollars spent by New York on the Medicaid program. Due to the massive reach and size of the Medicaid program in the state, it is estimated that the savings could exceed $4.5 billion annually.

"Billions in savings are billions of dollars in funding that can be delivered back to our schools, our roads and our residents. The creation of the Medicaid Inspector General will make sure that we can take the money from those who exploit a system designed to help people and put it to better use. The goal is to enable the Medicaid system to continue serving those who need it while ensuring that all the money is directed towards these necessary services," added Senator Flanagan. "This is a law that is designed to take money away from the crooks and give it back to the taxpayers of this state."