S T A T E O F N E W Y O R K
________________________________________________________________________
4444
2011-2012 Regular Sessions
I N A S S E M B L Y
February 3, 2011
___________
Introduced by M. of A. BOYLE -- read once and referred to the Committee
on Health
AN ACT to amend the public health law, in relation to establishing a
rewards program for individuals who provide relevant information to
the office of the Medicaid inspector general that leads to the
detection and conviction of persons engaging in Medicaid fraud; and to
amend the social services law, in relation to making technical
corrections thereto
THE PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND ASSEM-
BLY, DO ENACT AS FOLLOWS:
Section 1. The public health law is amended by adding a new section 37
to read as follows:
S 37. MEDICAID FRAUD; REWARDS FOR INFORMATION. 1. THE OFFICE OF THE
MEDICAID INSPECTOR GENERAL SHALL PAY A REWARD OF UP TO TEN PERCENT OF
AMOUNTS COLLECTED, OTHER THAN INTEREST, TO ANY INDIVIDUAL WHO PROVIDES
INFORMATION THAT LEADS TO THE DETECTION AND CONVICTION OF PERSONS ENGAG-
ING IN FRAUDULENT MEDICAID PRACTICES, AS DESCRIBED BY SECTION THREE
HUNDRED SIXTY-SIX-B OF THE SOCIAL SERVICES LAW.
2. THE FOLLOWING INDIVIDUALS MAY NOT FILE A CLAIM FOR THE REWARD
ESTABLISHED PURSUANT TO SUBDIVISION ONE OF THIS SECTION:
(A) PRESENT AND FORMER EMPLOYEES WHO RECEIVED THE INFORMATION IN THE
COURSE OF THEIR OFFICIAL DUTIES; OR
(B) THOSE WHO PARTICIPATED IN THE SCHEME TO DEFRAUD THE STATE OF MEDI-
CAID FUNDS.
AN EXECUTOR, ADMINISTRATOR, OR OTHER LEGAL REPRESENTATIVE MAY FILE A
CLAIM FOR REWARD ON BEHALF OF A DECEDENT IF THE DECEDENT WAS ELIGIBLE TO
FILE SUCH CLAIM BEFORE HIS OR HER DEATH. THE REPRESENTATIVE MUST ATTACH
TO THE CLAIM EVIDENCE OF THEIR AUTHORITY TO FILE.
3. AMOUNTS OF REWARDS SHALL BE DETERMINED BY THE MEDICAID INSPECTOR
GENERAL. INFORMATION WILL BE EVALUATED IN RELATION TO THE FACTS DEVEL-
OPED BY THE RESULTING INVESTIGATION. REWARDS WILL BE PAID IN PROPORTION
EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
[ ] is old law to be omitted.
LBD06983-01-1
A. 4444 2
TO THE VALUE OF INFORMATION VOLUNTARILY FURNISHED WITH RESPECT TO THE
AMOUNT OF FUNDS RECOVERED.
S 2. Section 366-b of the social services law, as added by chapter 306
of the laws of 1970, is amended to read as follows:
S 366-b. Penalties for fraudulent practices. 1. Any person who know-
ingly makes a false statement or representation, or who by deliberate
concealment of any material fact, or by impersonation or other fraudu-
lent device, obtains or attempts to obtain or aids or abets any person
to obtain medical assistance to which he OR SHE is not entitled, shall
be guilty of a class A misdemeanor, unless such act constitutes a
violation of a provision of the penal law of the state of New York, in
which case he OR SHE shall be punished in accordance with the penalties
fixed by such law.
2. Any person who, with intent to defraud, presents for allowance or
payment any false or fraudulent claim for furnishing services or
merchandise, or knowingly submits false information for the purpose of
obtaining greater compensation than that to which he OR SHE is legally
entitled for furnishing services or merchandise, or knowingly submits
false information for the purpose of obtaining authorization for
furnishing services or merchandise under this title, shall be guilty of
a class A misdemeanor, unless such act constitutes a violation of a
provision of the penal law of the state of New York, in which case he OR
SHE shall be punished in accordance with the penalties fixed by such
law.
S 3. The Medicaid inspector general shall promulgate rules and regu-
lations for the establishment of procedures for the provision of infor-
mation on persons engaging in fraudulent Medicaid practices and for the
implementation of the rewards program.
S 4. This act shall take effect immediately; provided, however that
section one of this act shall take effect January 1, 2013.