Senate Bill S4910

                            
                    S T A T E   O F   N E W   Y O R K
________________________________________________________________________

                                 4910--A

                       2011-2012 Regular Sessions

                            I N  S E N A T E

                             April 29, 2011
                               ___________

Introduced  by  Sens. KLEIN, CARLUCCI -- read twice and ordered printed,
  and when printed to be committed to the Committee on Finance -- recom-
  mitted to the Committee on Finance in accordance with Senate  Rule  6,
  sec.  8  --  committee  discharged, bill amended, ordered reprinted as
  amended and recommitted to said committee

AN ACT to amend the executive law, in relation to granting the office of
  the state inspector general jurisdiction over all state  agencies  and
  public  authorities  and  establishing  a  metropolitan transportation
  authority oversight unit within  such  office;  to  amend  the  public
  authorities law and the transportation law, in relation to eliminating
  the  office  of  the  metropolitan  transportation authority inspector
  general and establishing the office of the metropolitan transportation
  authority chief investigator; to amend the executive law, the tax law,
  the state finance law and the social  services  law,  in  relation  to
  eliminating the office of the welfare inspector general and the office
  of the medicaid inspector general, and transferring the duties, powers
  and  functions  thereof  to  the  deputy attorney general for medicaid
  fraud control; to repeal sections 46, 47, 48, 49 and 50 of the  execu-
  tive  law relating to the office of the welfare inspector general; and
  to repeal title 3 of article 1 of the public health  law  relating  to
  the office of the medicaid inspector general

  THE  PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND ASSEM-
BLY, DO ENACT AS FOLLOWS:

  Section 1. Section 51 of the executive law, as added by chapter 766 of
the laws of 2005, is amended to read as follows:
  S 51. Jurisdiction. This article shall,  subject  to  the  limitations
contained herein, confer upon the office of the state inspector general,
jurisdiction over all covered agencies. For the purposes of this article
"covered  agency"  shall  include all executive branch agencies, depart-
ments, divisions, officers, boards and commissions,  public  authorities
(other than multi-state or multi-national authorities), and public bene-

 EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                      [ ] is old law to be omitted.
                                                           LBD10235-03-2
              

S. 4910--A                          2

fit  corporations, the heads of which are appointed by the governor [and
which do not have their own inspector general by statute].   Wherever  a
covered  agency  is  a  board,  commission, a public authority or public
benefit corporation, the head of the agency is the chairperson thereof.
  S 2. Section 52 of the executive law is amended by adding a new subdi-
vision 4-a to read as follows:
  4-A. THE STATE INSPECTOR GENERAL SHALL ESTABLISH, WITHIN THE OFFICE OF
THE  STATE  INSPECTOR  GENERAL,  A METROPOLITAN TRANSPORTATION AUTHORITY
OVERSIGHT UNIT, AND SHALL APPOINT A DEPUTY INSPECTOR GENERAL TO SERVE AT
HIS OR HER PLEASURE, WHO SHALL BE RESPONSIBLE  FOR  CONDUCTING  INVESTI-
GATIONS  IN  THE METROPOLITAN TRANSPORTATION AUTHORITY PURSUANT TO TITLE
ELEVEN OF ARTICLE FIVE OF THE PUBLIC AUTHORITIES LAW.
  S 3. Subdivision 21 of section 1261 of the public authorities law,  as
amended  by  section  1  of part H of chapter 25 of the laws of 2009, is
amended to read as follows:
  21. ["Inspector general"] "CHIEF INVESTIGATOR" shall mean  the  metro-
politan transportation authority [inspector general] CHIEF INVESTIGATOR.
  S  4.  Paragraph  (a) of subdivision 2 of section 1269-g of the public
authorities law, as amended by section 13 of part H of chapter 25 of the
laws of 2009, is amended to read as follows:
  (a) provide the telephone numbers and addresses to report  information
of  fraud  or  other illegal activity to the appropriate officers of the
[inspector general] CHIEF INVESTIGATOR of the authority and  the  attor-
ney-general of the state;
  S  5.  Section 1279 of the public authorities law, as added by chapter
427 of the laws of 1983, paragraph (e) of subdivision 4  as  amended  by
chapter 322 of the laws of 1985, subdivision 6 as amended by chapter 927
of the laws of 1984, is amended to read as follows:
  S  1279.  Metropolitan  transportation  authority  [inspector general]
CHIEF INVESTIGATOR.   1. There is hereby  created  in  the  metropolitan
transportation   authority  an  office  of  metropolitan  transportation
authority [inspector general] CHIEF INVESTIGATOR.  The [inspector gener-
al] CHIEF INVESTIGATOR shall be  appointed  by  the  governor  with  the
advice and consent of the senate. The [inspector general] CHIEF INVESTI-
GATOR  shall,  prior  to  his  OR HER appointment, have had at least ten
years experience in the management of transportation services, in audit-
ing and investigation of governmental operations, or in services related
to management and productivity improvement. The term of  office  of  the
[inspector  general]  CHIEF  INVESTIGATOR  shall  be five years from the
effective date of appointment, and he OR SHE shall serve at the pleasure
of the governor. The salary of the [inspector  general]  CHIEF  INVESTI-
GATOR shall be determined by the authority board.
  2. The [inspector general] CHIEF INVESTIGATOR shall annually submit to
the  board of the metropolitan transportation authority a budget request
for the operation of the office. If the board disapproves any portion of
such request and the  commissioner  of  transportation  determines  such
disapproval  to  be  unreasonable, such commissioner shall withhold from
payments due such authority, the amount so determined to be unreasonable
and transfer such amount to the office of the  metropolitan  transporta-
tion authority [inspector general] CHIEF INVESTIGATOR.
  3.  The  [inspector  general]  CHIEF INVESTIGATOR AND THE METROPOLITAN
TRANSPORTATION AUTHORITY OVERSIGHT UNIT  OF  THE  OFFICE  OF  THE  STATE
INSPECTOR  GENERAL  shall  have  full  and  unrestricted  access  to all
records,  information,  data,  reports,  plans,  projections,   matters,
contracts,  memoranda,  correspondence  and  any  other materials of the
authority and its subsidiaries, the Long Island  [railroad]  RAIL  ROAD,

S. 4910--A                          3

metro-north  railroad,  metropolitan  suburban  bus authority and Staten
Island rapid transit operating authority, of the Triborough  bridge  and
tunnel  authority,  and  of  the New York city transit authority and its
subsidiary, the Manhattan and Bronx surface transit operating authority,
or any other agency that may come under the control of the authority, or
within their custody or control.
  4.  The  [inspector  general]  CHIEF INVESTIGATOR, notwithstanding the
provisions of title nine of this article and this title,  and  of  title
three  of  article three OF THIS CHAPTER, shall have the following func-
tions, powers and duties:
  (a) to receive and investigate complaints from any source or upon  his
OR  HER  own  initiative  concerning  alleged abuses, frauds and service
deficiencies, including deficiencies in the maintenance and operation of
facilities, relating to the authority and its subsidiaries as listed  in
subdivision  two  [above]  OF  THIS  SECTION,  the Triborough bridge and
tunnel authority and the New York city transit authority and its subsid-
iary;
  (b) to initiate such reviews as he OR SHE may deem appropriate of  the
operations  of  the authority and its subsidiaries as listed in subdivi-
sion two [above] OF THIS  SECTION,  the  Triborough  bridge  and  tunnel
authority, or the New York city transit authority and its subsidiary, in
order  to  identify  areas  in  which  performance might be improved and
available funds used more effectively;
  (c) to recommend remedial actions to be taken by the authority and its
subsidiaries as listed in subdivision two of this section,  the  Tribor-
ough bridge and tunnel authority, and the New York city transit authori-
ty  and  its subsidiary, to overcome or correct operating or maintenance
deficiencies and inefficiencies that he OR SHE determines to exist;
  (d) to make available to appropriate law enforcement officials  infor-
mation  and  evidence  which  relate to criminal acts that he OR SHE may
obtain in carrying out his OR HER duties;
  (e) to subpoena witnesses,  administer  oaths  or  affirmations,  take
testimony  and  compel the production of such books, papers, records and
documents as he OR SHE may deem to be relevant to any inquiry or  inves-
tigation  undertaken  pursuant  to  this  section  [and to delegate such
powers to a duly authorized deputy inspector general];
  (f) to monitor the implementation by the  authority  and  its  subsid-
iaries,  the  [Triborugh] TRIBOROUGH bridge and tunnel authority and the
New York city transit authority and its  subsidiary  of  recommendations
made  by the [inspector general] CHIEF INVESTIGATOR, THE STATE INSPECTOR
GENERAL or other audit agencies; and
  (g) to do all things necessary to carry out the functions, powers  and
duties set forth in this section.
  5. The [inspector general] CHIEF INVESTIGATOR shall cooperate, consult
and  coordinate  with  the state public transportation safety board with
regard to any activity concerning the  operations  of  the  metropolitan
transportation authority. With respect to any accident on the facilities
of the metropolitan transportation authority, the primary responsibility
for investigation shall be that of the board which shall share its find-
ings  with the metropolitan transportation authority [inspector general]
CHIEF INVESTIGATOR AND THE METROPOLITAN TRANSPORTATION  AUTHORITY  OVER-
SIGHT UNIT OF THE OFFICE OF THE STATE INSPECTOR GENERAL.
  6. The [inspector general] CHIEF INVESTIGATOR shall make annual public
reports  on his OR HER findings and recommendations. Such a report shall
be filed in the office of the governor and with the  legislature  on  or
before  the  first day of February for the preceding year. The metropol-

S. 4910--A                          4

itan transportation authority and its  applicable  constituent  agencies
shall  prepare  a response to the annual report and to any and all other
final reports made by the [inspector general] CHIEF INVESTIGATOR  within
thirty  days  of  receipt,  which time may be extended by the [inspector
general] CHIEF INVESTIGATOR in his OR HER discretion, indicating whether
such authority intends to implement the recommendations in such reports,
and, if not, why  not.  In  addition,  the  metropolitan  transportation
authority  and  its applicable constituent agencies shall give quarterly
reports to the [inspector  general]  CHIEF  INVESTIGATOR  outlining  the
status  of  each  of the recommendations made by the [inspector general]
CHIEF INVESTIGATOR in his OR HER final reports. Copies of all  of  these
reports  shall  be  sent to the governor, the temporary president of the
senate, the speaker of the assembly, the chairman of the  senate  trans-
portation  committee,  the chairman of the senate finance committee, the
chairman of  the  assembly  corporations,  authorities  and  commissions
committee and the chairman of the assembly ways and means committee.
  7. To effectuate the purposes of this section, the [inspector general]
CHIEF  INVESTIGATOR  may  request  from  any  department, board, bureau,
commission, office or other agency of the state, or of any of its  poli-
tical  subdivisions,  such cooperation, assistance, services and data as
will enable him OR HER to carry out his OR  HER  functions,  powers  and
duties  hereunder,  and they are authorized and directed to provide said
cooperation, assistance, services and data.
  S 6. Section 216 of the transportation law, as amended by chapter  431
of  the laws of 1983, subdivision 1 as amended by chapter 84 of the laws
of 1985, is amended to read as follows:
  S 216. State public transportation safety board. 1.  There  is  hereby
created  in  the  department  a  board,  to be known as the state public
transportation safety board.  Such board shall be  responsible  for  the
investigation of accidents involving public transportation in the state,
including  commuter  rail,  subways,  rapid transit and buses. The board
shall also be responsible for the presentation of recommendations to all
public transportation operators and carriers to prevent  the  occurrence
of  future  accidents.  Such board shall consist of the commissioner and
six other members, no more than three of whom shall belong to  the  same
political  party.  Two  of the members of the board shall be selected by
the governor from a list submitted by the  temporary  president  of  the
senate and two from a list submitted by the speaker of the assembly. The
remaining  two  members shall be selected by the governor. One from each
category of selected members shall have  competence  and  experience  in
connection  with the operation, design or management of public transpor-
tation facilities and systems. Three of  the  members,  other  than  the
commissioner,  shall  be  from the metropolitan transportation authority
region and three members shall be from areas of the state  outside  such
region. All appointees to the board other than the commissioner shall be
upon  the advice and consent of the senate. The metropolitan transporta-
tion authority [inspector general] CHIEF INVESTIGATOR  shall  be  an  ex
officio  member  of  the board but shall have no vote on matters arising
outside of the operations of the metropolitan transportation  authority.
Provided,  however,  that  with  the  exception  of the commissioner, no
elected or appointed public officer or transportation  authority  member
shall  be  eligible  for  membership  on  such board. The governor shall
select a [chairman] CHAIR from the  members  but  the  [chairman]  CHAIR
shall  be  someone  other than the metropolitan transportation authority
[inspector general] CHIEF INVESTIGATOR.

S. 4910--A                          5

  2. The board may be called to investigate any accident by the governor
or chairman. Alternatively, any board member may call  for  an  investi-
gation with majority board concurrence.
  3.  Except  for  the  commissioner and the metropolitan transportation
authority [inspector general] CHIEF INVESTIGATOR, the term of office  of
each  such  member  shall  be  six  years, except that the members first
selected shall serve for terms of six years,  five  years,  four  years,
three  years, two years and one year, respectively. Any member appointed
to fill a vacancy occurring otherwise than by expiration of a term shall
be appointed for the remainder of the unexpired term.
  4. Members of the board, except the commissioner and the  metropolitan
transportation  authority  [inspector general] CHIEF INVESTIGATOR, shall
receive one hundred fifty dollars per diem, not to exceed  ten  thousand
dollars  per  annum  compensation  for  their services as members of the
board, and each of them  shall  be  allowed  the  necessary  and  actual
expenses  which  he  OR SHE shall incur in the performance of his OR HER
duties under this article.
  S 7. Subdivision 2 of section 219 of the transportation law, as  added
by chapter 431 of the laws of 1983, is amended to read as follows:
  2.  The  board shall cooperate, consult and coordinate with the metro-
politan transportation authority [inspector general] CHIEF  INVESTIGATOR
with  regard  to any activity concerning the operations of the metropol-
itan transportation authority. With  respect  to  any  accident  on  the
facilities  of  the  metropolitan  transportation authority, the primary
responsibility for investigation shall be that of the board which  shall
share  its  findings  with  the  metropolitan  transportation  authority
[inspector general] CHIEF INVESTIGATOR AND THE METROPOLITAN  TRANSPORTA-
TION  AUTHORITY  OVERSIGHT  UNIT  OF  THE  OFFICE OF THE STATE INSPECTOR
GENERAL.
  S 8. The office of the metropolitan transportation authority inspector
general is abolished. When the term "metropolitan transportation author-
ity inspector general" or any equivalent expression thereof is  used  in
the public authorities law or any other law such inspector general shall
be deemed to mean and refer to the metropolitan transportation authority
chief investigator.
  S  9. Transfer of functions. All of the functions and powers possessed
by all and all of the obligations and duties of the office of the metro-
politan transportation authority inspector general are  transferred  and
assigned to, assumed by and devolved upon the office of the metropolitan
transportation  authority  chief  investigator,  in  accordance with and
pursuant to the provisions of this act.
  S 10. Upon the abolition of the office of the metropolitan transporta-
tion authority inspector general all appropriations made  thereto  shall
be reallocated as follows:
  (a)  ten percent thereof to the office of the metropolitan transporta-
tion authority chief investigator;
  (b) forty percent thereof to the metropolitan transportation authority
oversight unit of the office of the state inspector general; and
  (c) fifty percent thereof to the general fund of the state treasury.
  S 11. Continuity of authority. For the purpose of  succession  to  all
duties,  functions,  powers and obligations transferred and assigned to,
devolved upon and assumed by the office of the metropolitan  transporta-
tion  authority  chief  investigator  pursuant  to this act, such office
shall be deemed and held to constitute the continuation of the office of
the metropolitan  transportation  authority  inspector  general  as  the
content of subject matter requires.

S. 4910--A                          6

  S  12.  Sections  46,  47,  48,  49  and  50  of the executive law are
REPEALED.
  S  13.  Section 74 of the executive law, as added by chapter 41 of the
laws of 1992, is amended to read as follows:
  S 74. [Welfare inspector general] MEDICAID FRAUD CONTROL.    1.  Defi-
nitions.  For  the  purposes  of this section, the following definitions
shall apply:
  a. ["Inspector" means the welfare inspector general  created  by  this
section] "DEPUTY ATTORNEY GENERAL" MEANS THE DEPUTY ATTORNEY GENERAL FOR
MEDICAID FRAUD CONTROL.
  b.  "Investigation"  means, investigations of fraud, abuse, or illegal
acts perpetrated within  the  department  of  [social  services]  FAMILY
ASSISTANCE  OR  THE  DEPARTMENT  OF  HEALTH,  or  local  social services
districts, or by contractees or recipients of public assistance services
as provided by the department of [social services] FAMILY ASSISTANCE  OR
OF MEDICAL ASSISTANCE AS PROVIDED BY THE DEPARTMENT OF HEALTH.
  c.  "Office"  means  the  office  of  the  [welfare  inspector general
created] DEPUTY ATTORNEY GENERAL FOR MEDICAID FRAUD CONTROL CONTINUED by
this section.
  2. [a.] There is hereby [created] CONTINUED in the department  of  law
[within],  the  office of the deputy attorney general for medicaid fraud
control [an office of welfare inspector  general].    The  head  of  the
office  shall be the [welfare inspector general] DEPUTY ATTORNEY GENERAL
FOR MEDICAID FRAUD CONTROL, who shall be appointed by the [governor,  by
and with the advice and consent of the senate] ATTORNEY GENERAL.
  [b.  The inspector shall serve for a term of five years unless removed
by the governor for neglect or malfeasance in office, and  may  also  be
removed  for  neglect  or  malfeasance by the senate upon a vote of two-
thirds of its members. An inspector removed from office may not be reap-
pointed to such office.
  c. The inspector may not be employed with  the  department  of  social
services during his employment with the office or within two years after
terminating employment with the office.]
  3.  Functions,  duties  and  responsibilities.  The [inspector] DEPUTY
ATTORNEY GENERAL shall have the following functions, duties and  respon-
sibilities:
  a.  to  appoint such [deputies, directors,] assistants and other offi-
cers and employees as may be needed for the performance of  his  OR  HER
duties  and may prescribe their powers and fix their compensation within
the amounts appropriated therefor;
  b. to conduct and supervise investigations relating to the programs of
the department of [social services] FAMILY ASSISTANCE AND THE DEPARTMENT
OF HEALTH and, to the  greatest  extent  possible,  to  coordinate  such
activities   with  [the  deputy  attorney  general  for  medicaid  fraud
control,] the commissioner of [social services] TEMPORARY AND DISABILITY
ASSISTANCE, THE  COMMISSIONER  OF  CHILDREN  AND  FAMILY  SERVICES,  the
commissioner  of health, the commissioner of education, the fiscal agent
employed to operate the medicaid management information system, and  the
state comptroller;
  c.  to  keep the governor, attorney general, state comptroller, TEMPO-
RARY president [pro tem] and minority leader of the senate, the  speaker
and the minority and majority leaders of the assembly, apprised of fraud
and abuse;
  d.  to  prosecute  fraud, abuse or illegal acts perpetrated within the
department of [social services] FAMILY ASSISTANCE, DEPARTMENT OF  HEALTH

S. 4910--A                          7

or  local  social services districts, or by contractees or recipients of
public assistance services;
  e. to make information and evidence relating to criminal acts which he
OR  SHE may obtain in carrying out his OR HER duties available to appro-
priate law enforcement officials and to consult with [the deputy  attor-
ney  general for medicaid fraud control and] local district attorneys to
coordinate investigations and criminal prosecutions;
  f. to subpoena  witnesses,  administer  oaths  or  affirmations,  take
testimony  and  compel the production of such books, papers, records and
documents as he OR SHE may deem  to  be  relevant  to  an  investigation
undertaken pursuant to this section;
  g.  to monitor the implementation by the relevant office of his OR HER
recommendations and those of other investigative agencies;
  h. to recommend policies relating to the prevention and  detection  of
fraud and abuse or the identification and prosecution of participants in
such fraud or abuse; and
  i.  to receive complaints of alleged failures of state and local offi-
cials to prevent, detect and prosecute fraud and abuse.
  4. Cooperation of agency officials and employees. a.  In  addition  to
the authority otherwise provided by this section, the [inspector] DEPUTY
ATTORNEY  GENERAL,  in  carrying  out the provisions of this section, is
authorized:
  (i) to have full and unrestricted  access  to  all  records,  reports,
audits,  reviews,  documents,  papers, recommendations or other material
available to the department of [social services] FAMILY ASSISTANCE,  THE
DEPARTMENT  OF  HEALTH  and  local social services districts relating to
programs and operations with respect to  which  the  [inspector]  DEPUTY
ATTORNEY GENERAL has responsibilities under this section;
  (ii) to make such investigations relating to the administration of the
programs  and  operations  of the department of [social services] FAMILY
ASSISTANCE AND THE DEPARTMENT OF HEALTH as are, in the judgment  of  the
[inspector] DEPUTY ATTORNEY GENERAL, necessary or desirable; and
  (iii) to request such information, assistance and cooperation from any
federal,  state or local governmental department, board, bureau, commis-
sion, or other agency or unit thereof as may be necessary  for  carrying
out  the  duties  and  responsibilities enjoined upon him OR HER by this
section. State and local agencies or units thereof are hereby authorized
and directed to provide such information, assistance and cooperation.
  b. Notwithstanding any other provision of law, rule or  regulation  to
the  contrary, no person shall prevent, seek to prevent, interfere with,
obstruct or otherwise hinder any investigation being conducted  pursuant
to  this  section. Section one hundred thirty-six of the social services
law shall in no way be construed to restrict any person or  governmental
body  from  cooperating  and  assisting  the [inspector] DEPUTY ATTORNEY
GENERAL or his OR HER employees in carrying out their duties under  this
section.  Any  violation  of  this  paragraph shall constitute cause for
suspension or removal from office or employment.
  5. [Establishment period. The  governor  shall  nominate  the  initial
inspector  as  soon  as  is practicable but in no event later than sixty
days after the effective date of this section.
  6.] Reports required of the [inspector] DEPUTY ATTORNEY  GENERAL.  The
[inspector]  DEPUTY ATTORNEY GENERAL shall, no later than February first
of each year submit to the governor, the state comptroller, the attorney
general and the legislature a report summarizing the activities  of  the
office during the preceding calendar year.

S. 4910--A                          8

  [7.]  6. Disclosure of information. a. The [inspector] DEPUTY ATTORNEY
GENERAL shall not publicly disclose information which is:
  (i) a part of any ongoing investigation; or
  (ii) specifically prohibited from disclosure by any other provision of
law.
  b.  Notwithstanding  paragraph a of this subdivision, any report under
this section may be disclosed to the public in  a  form  which  includes
information  with respect to a part of an ongoing criminal investigation
if such information has been included in a public record.
  S 14. The executive law is amended by adding two new sections  75  and
76 to read as follows:
  S  75. FUNCTIONS, POWERS AND DUTIES OF THE DEPUTY ATTORNEY GENERAL FOR
MEDICAID FRAUD CONTROL. THE DEPUTY ATTORNEY GENERAL FOR  MEDICAID  FRAUD
CONTROL  SHALL, NOTWITHSTANDING ANY PROVISION OF THE SOCIAL SERVICES LAW
TO THE CONTRARY, HAVE THE FOLLOWING FUNCTIONS, POWERS AND DUTIES:
  1. TO PREVENT, DETECT AND INVESTIGATE FRAUD AND ABUSE WITH THE  PUBLIC
ASSISTANCE AND MEDICAL ASSISTANCE SYSTEMS;
  2. TO REFER APPROPRIATE CASES FOR CRIMINAL PROSECUTION;
  3.  TO  RECOVER  IMPROPERLY  EXPENDED  PUBLIC ASSISTANCE   AND MEDICAL
ASSISTANCE FUNDS;
  4. TO CONDUCT AND SUPERVISE ACTIVITIES TO PREVENT, DETECT AND INVESTI-
GATE PUBLIC ASSISTANCE AND MEDICAL ASSISTANCE PROGRAM  FRAUD  AND  ABUSE
AMONGST  THE  FOLLOWING: THE DEPARTMENT OF HEALTH; THE OFFICES OF MENTAL
HEALTH, FOR  PEOPLE  WITH  DEVELOPMENTAL  DISABILITIES,  ALCOHOLISM  AND
SUBSTANCE  ABUSE SERVICES, TEMPORARY DISABILITY ASSISTANCE, AND CHILDREN
AND FAMILY SERVICES;
  5. TO COORDINATE, TO  THE  GREATEST  EXTENT  POSSIBLE,  ACTIVITIES  TO
PREVENT, DETECT AND INVESTIGATE PUBLIC ASSISTANCE AND MEDICAL ASSISTANCE
PROGRAM FRAUD AND ABUSE AMONGST THE FOLLOWING: THE DEPARTMENT OF HEALTH;
THE  OFFICES  OF  MENTAL HEALTH, FOR PEOPLE WITH DEVELOPMENTAL DISABILI-
TIES, ALCOHOLISM AND  SUBSTANCE  ABUSE  SERVICES,  TEMPORARY  DISABILITY
ASSISTANCE,  AND CHILDREN AND FAMILY SERVICES; THE COMMISSION ON QUALITY
OF CARE AND  ADVOCACY  FOR  PERSONS  WITH  DISABILITIES;  THE  EDUCATION
DEPARTMENT;  THE FISCAL AGENT EMPLOYED TO OPERATE THE MEDICAL ASSISTANCE
INFORMATION AND PAYMENT SYSTEM; LOCAL GOVERNMENTS AND ENTITIES;  AND  TO
WORK  IN  A  COORDINATED  AND  COOPERATIVE  MANNER WITH, TO THE GREATEST
EXTENT POSSIBLE, FEDERAL  PROSECUTORS,  DISTRICT  ATTORNEYS  WITHIN  THE
STATE,  THE SPECIAL INVESTIGATIVE UNIT MAINTAINED BY EACH HEALTH INSURER
OPERATING WITHIN THE STATE, AND THE STATE COMPTROLLER;
  6. TO SOLICIT, RECEIVE AND INVESTIGATE COMPLAINTS RELATED TO FRAUD AND
ABUSE WITHIN THE PUBLIC ASSISTANCE AND MEDICAL ASSISTANCE PROGRAM;
  7. TO KEEP THE GOVERNOR, ATTORNEY GENERAL, STATE  COMPTROLLER,  TEMPO-
RARY  PRESIDENT  AND  MINORITY LEADER OF THE SENATE, THE SPEAKER AND THE
MINORITY LEADER OF THE ASSEMBLY, AND THE HEADS OF AGENCIES WITH  RESPON-
SIBILITY  FOR  THE  ADMINISTRATION  OF THE PUBLIC ASSISTANCE AND MEDICAL
ASSISTANCE PROGRAMS APPRISED OF EFFORTS TO PREVENT, DETECT, INVESTIGATE,
AND PROSECUTE FRAUD AND ABUSE WITHIN THE PUBLIC ASSISTANCE  AND  MEDICAL
ASSISTANCE PROGRAMS;
  8.  TO PURSUE CIVIL AND ADMINISTRATIVE ENFORCEMENT ACTIONS AGAINST ANY
INDIVIDUAL OR ENTITY THAT ENGAGES IN FRAUD, ABUSE, OR ILLEGAL OR IMPROP-
ER ACTS OR UNACCEPTABLE PRACTICES PERPETRATED WITHIN THE PUBLIC  ASSIST-
ANCE  AND MEDICAL ASSISTANCE PROGRAMS, INCLUDING BUT NOT LIMITED TO: (A)
REFERRAL OF INFORMATION AND EVIDENCE TO REGULATORY AGENCIES  AND  LICEN-
SURE  BOARDS;  (B)  WITHHOLDING PAYMENT OF PUBLIC ASSISTANCE AND MEDICAL
ASSISTANCE FUNDS IN ACCORDANCE WITH STATE AND  FEDERAL  LAWS  AND  REGU-
LATIONS;  (C)  IMPOSITION  OF  ADMINISTRATIVE SANCTIONS AND PENALTIES IN

S. 4910--A                          9

ACCORDANCE WITH STATE AND FEDERAL LAWS AND REGULATIONS; (D) EXCLUSION OF
PROVIDERS, VENDORS AND CONTRACTORS FROM PARTICIPATION  IN  THE  PROGRAM;
(E)  INITIATING  AND  MAINTAINING  ACTIONS FOR CIVIL RECOVERY AND, WHERE
AUTHORIZED  BY  LAW,  SEIZURE OF PROPERTY OR OTHER ASSETS CONNECTED WITH
IMPROPER PAYMENTS; AND ENTERING INTO CIVIL SETTLEMENTS; AND (F) RECOVERY
OF IMPROPERLY EXPENDED PUBLIC ASSISTANCE AND MEDICAL ASSISTANCE  PROGRAM
FUNDS  FROM  THOSE  WHO ENGAGE IN FRAUD OR ABUSE, OR ILLEGAL OR IMPROPER
ACTS PERPETRATED WITHIN THE PUBLIC  ASSISTANCE  AND  MEDICAL  ASSISTANCE
PROGRAMS.  IN  THE  PURSUIT OF SUCH CIVIL AND ADMINISTRATIVE ENFORCEMENT
ACTIONS UNDER  THIS  SUBDIVISION,  THE  DEPUTY  ATTORNEY  GENERAL  SHALL
CONSIDER  THE  QUALITY AND AVAILABILITY OF MEDICAL CARE AND SERVICES AND
THE BEST INTEREST OF BOTH THE MEDICAL ASSISTANCE PROGRAM AND RECIPIENTS;
  9. TO MAKE INFORMATION AND EVIDENCE  RELATING  TO  SUSPECTED  CRIMINAL
ACTS WHICH HE OR SHE MAY OBTAIN IN CARRYING OUT HIS OR HER DUTIES AVAIL-
ABLE  TO APPROPRIATE LAW ENFORCEMENT OFFICIALS AND TO CONSULT WITH OTHER
STATE AND FEDERAL LAW ENFORCEMENT OFFICIALS FOR COORDINATION OF CRIMINAL
INVESTIGATIONS AND PROSECUTIONS.   THE  DEPUTY  ATTORNEY  GENERAL  SHALL
REFER  SUSPECTED  FRAUD  OR CRIMINALITY TO THE ATTORNEY GENERAL AND MAKE
ANY OTHER REFERRALS TO SUCH ATTORNEY GENERAL AS REQUIRED OR CONTEMPLATED
BY FEDERAL LAW. AT ANY TIME AFTER SUCH REFERRAL, WITH TEN  DAYS  WRITTEN
NOTICE  TO  THE  ATTORNEY  GENERAL  OR SUCH SHORTER TIME AS THE ATTORNEY
GENERAL CONSENTS  TO,  THE  DEPUTY  ATTORNEY  GENERAL  MAY  ADDITIONALLY
PROVIDE RELEVANT INFORMATION ABOUT SUSPECTED FRAUD OR CRIMINALITY TO ANY
OTHER  FEDERAL  OR STATE LAW ENFORCEMENT AGENCY THAT THE DEPUTY ATTORNEY
GENERAL DEEMS APPROPRIATE UNDER THE CIRCUMSTANCES;
  10. TO SUBPOENA AND ENFORCE THE ATTENDANCE  OF  WITNESSES,  ADMINISTER
OATHS OR AFFIRMATIONS, EXAMINE WITNESSES UNDER OATH, AND TAKE TESTIMONY;
  11.  TO  REQUIRE  AND  COMPEL  THE  PRODUCTION  OF SUCH BOOKS, PAPERS,
RECORDS AND DOCUMENTS AS HE OR SHE MAY DEEM TO BE RELEVANT  OR  MATERIAL
TO  AN  INVESTIGATION, EXAMINATION OR REVIEW UNDERTAKEN PURSUANT TO THIS
SECTION;
  12. TO EXAMINE AND COPY OR REMOVE DOCUMENTS OR  RECORDS  OF  ANY  KIND
RELATED  TO  THE  PUBLIC  ASSISTANCE  AND MEDICAL ASSISTANCE PROGRAMS OR
NECESSARY FOR THE DEPUTY ATTORNEY GENERAL TO PERFORM HIS OR  HER  DUTIES
AND  RESPONSIBILITIES THAT ARE PREPARED, MAINTAINED OR HELD BY OR AVAIL-
ABLE TO ANY STATE AGENCY OR LOCAL GOVERNMENTAL ENTITY  THE  PATIENTS  OR
CLIENTS OF WHICH ARE SERVED BY THE PUBLIC ASSISTANCE AND MEDICAL ASSIST-
ANCE  PROGRAMS,  OR  WHICH  IS  OTHERWISE RESPONSIBLE FOR THE CONTROL OF
FRAUD AND ABUSE WITHIN THE  PUBLIC  ASSISTANCE  AND  MEDICAL  ASSISTANCE
PROGRAMS;  PROVIDED,  HOWEVER,  THAT  ANY  SUCH  INFORMATION BE AFFORDED
CONFIDENTIALITY PROTECTION AS PROVIDED FOR UNDER STATE AND FEDERAL  LAW.
THE  REMOVAL OF RECORDS SHALL BE LIMITED TO THOSE CIRCUMSTANCES IN WHICH
A COPY THEREOF IS INSUFFICIENT FOR AN APPROPRIATE LEGAL OR INVESTIGATIVE
PURPOSE, PROVIDED THAT IN SUCH INSTANCES THE COPYING AND RETURN OF  SUCH
ORIGINAL,  OR  COPY  WHERE  THE  ORIGINAL IS REQUIRED FOR AN APPROPRIATE
LEGAL OR INVESTIGATIVE PURPOSE, IS EXPEDITED AND SUCH ORIGINAL  OR  COPY
IS READILY ACCESSIBLE IN ACCORDANCE WITH THE CARE AND TREATMENT NEEDS OF
THE PATIENT;
  13. TO RECOMMEND AND IMPLEMENT POLICIES RELATING TO THE PREVENTION AND
DETECTION  OF FRAUD AND ABUSE; PROVIDED HOWEVER, THAT THE CONSENT OF THE
ATTORNEY GENERAL SHALL BE OBTAINED PRIOR TO THE  IMPLEMENTATION  OF  ANY
POLICY THAT SHALL AFFECT THE OPERATIONS OF THE DEPARTMENT OF LAW;
  14.  TO  MONITOR THE IMPLEMENTATION OF ANY RECOMMENDATIONS MADE BY THE
OFFICE TO AGENCIES OR OTHER ENTITIES WITH  RESPONSIBILITY  FOR  ADMINIS-
TRATION OF THE PUBLIC ASSISTANCE AND MEDICAL ASSISTANCE PROGRAMS;

S. 4910--A                         10

  15.  TO  PREPARE  CASES,  PROVIDE TESTIMONY AND SUPPORT ADMINISTRATIVE
HEARINGS AND OTHER LEGAL PROCEEDINGS;
  16. TO REVIEW AND AUDIT CONTRACTS, COST REPORTS, CLAIMS, BILLS AND ALL
OTHER  EXPENDITURES  OF PUBLIC ASSISTANCE AND MEDICAL ASSISTANCE PROGRAM
FUNDS TO DETERMINE COMPLIANCE WITH APPLICABLE FEDERAL AND STATE LAWS AND
REGULATIONS AND TAKE SUCH ACTIONS AS ARE AUTHORIZED BY FEDERAL OR  STATE
LAWS AND REGULATIONS;
  17.  TO  WORK  WITH  THE FISCAL AGENT EMPLOYED TO OPERATE THE MEDICAID
MANAGEMENT INFORMATION SYSTEM TO OPTIMIZE THE SYSTEM;
  18. TO WORK IN A COORDINATED MANNER  WITH  RELEVANT  AGENCIES  IN  THE
IMPLEMENTATION  OF INFORMATION TECHNOLOGY RELATING TO THE PREVENTION AND
IDENTIFICATION OF FRAUD AND ABUSE IN THE PUBLIC ASSISTANCE  AND  MEDICAL
ASSISTANCE  PROGRAMS,  INCLUDING  THE  SURVEILLANCE  UTILIZATION  REVIEW
SYSTEM AND OTHER AUTOMATED SYSTEMS PURSUANT TO PARAGRAPH (B) OF SUBDIVI-
SION EIGHT OF SECTION THREE HUNDRED SIXTY-SEVEN-B OF THE SOCIAL SERVICES
LAW;
  19. TO CONDUCT EDUCATIONAL PROGRAMS FOR PUBLIC ASSISTANCE AND  MEDICAL
ASSISTANCE  PROGRAMS  PROVIDERS,  VENDORS,  CONTRACTORS  AND  RECIPIENTS
DESIGNED TO LIMIT FRAUD AND  ABUSE  WITHIN  THE  PUBLIC  ASSISTANCE  AND
MEDICAL ASSISTANCE PROGRAMS;
  20.  TO,  IN  CONJUNCTION  WITH THE COMMISSIONER, DEVELOP PROTOCOLS TO
FACILITATE THE EFFICIENT SELF-DISCLOSURE AND COLLECTION OF  OVERPAYMENTS
AND MONITOR SUCH COLLECTIONS, INCLUDING THOSE THAT ARE SELF-DISCLOSED BY
PROVIDERS. THE PROVIDER'S GOOD FAITH SELF-DISCLOSURE OF OVERPAYMENTS MAY
BE CONSIDERED AS A MITIGATING FACTOR IN THE DETERMINATION OF AN ADMINIS-
TRATIVE ENFORCEMENT ACTION;
  21.  TO  RECEIVE  AND TO INVESTIGATE COMPLAINTS OF ALLEGED FAILURES OF
STATE AND LOCAL OFFICIALS TO PREVENT, DETECT  AND  PROSECUTE  FRAUD  AND
ABUSE IN THE PUBLIC ASSISTANCE AND MEDICAL ASSISTANCE PROGRAMS;
  22.  TO,  CONSISTENT  WITH  PROVISIONS  OF THIS ARTICLE, IMPLEMENT AND
AMEND, AS NEEDED, RULES AND  REGULATIONS  RELATING  TO  THE  PREVENTION,
DETECTION,  INVESTIGATION  AND  REFERRAL  OF  FRAUD AND ABUSE WITHIN THE
PUBLIC ASSISTANCE AND MEDICAL ASSISTANCE PROGRAMS AND  THE  RECOVERY  OF
IMPROPERLY  EXPENDED  PUBLIC  ASSISTANCE  AND MEDICAL ASSISTANCE PROGRAM
FUNDS;
  23. TO CONDUCT, IN THE CONTEXT  OF  THE  INVESTIGATION  OF  FRAUD  AND
ABUSE, ON-SITE FACILITY AND OFFICE INSPECTIONS;
  24.  TO  TAKE APPROPRIATE ACTIONS TO ENSURE THAT THE PUBLIC ASSISTANCE
AND MEDICAL ASSISTANCE PROGRAMS ARE THE PAYOR OF LAST RESORT; AND
  25. TO PERFORM ANY OTHER FUNCTIONS THAT ARE NECESSARY  OR  APPROPRIATE
TO  FULFILL  THE DUTIES AND RESPONSIBILITIES OF THE OFFICE IN ACCORDANCE
WITH FEDERAL AND STATE LAW.
  S 76. COOPERATION OF AGENCY OFFICIALS AND EMPLOYEES. 1. IN ADDITION TO
THE AUTHORITY OTHERWISE PROVIDED BY THIS ARTICLE, THE OFFICE, IN  CARRY-
ING  OUT  THE  PROVISIONS OF THIS ARTICLE, IS AUTHORIZED TO REQUEST SUCH
INFORMATION, ASSISTANCE AND COOPERATION FROM ANY FEDERAL, STATE OR LOCAL
GOVERNMENTAL DEPARTMENT, BOARD, BUREAU, COMMISSION, OR OTHER  AGENCY  OR
UNIT THEREOF AS MAY BE NECESSARY FOR CARRYING OUT THE DUTIES AND RESPON-
SIBILITIES  ENJOINED  UPON  THE  OFFICE BY THIS ARTICLE. STATE AND LOCAL
AGENCIES OR UNITS THEREOF ARE HEREBY AUTHORIZED AND DIRECTED TO  PROVIDE
TO  THE  OFFICE,  OR, AT THE REQUEST OF THE OFFICE, TO STATE AGENCIES OR
THEIR  CONTRACTORS,  SUCH  INFORMATION,  ASSISTANCE   AND   COOPERATION.
NOTWITHSTANDING ANY OTHER PROVISION OF LAW TO THE CONTRARY, REQUESTS FOR
INFORMATION,  ASSISTANCE AND COOPERATION MAY INCLUDE, BUT NOT BE LIMITED
TO, ALL STATE AND LOCAL GOVERNMENT BIRTH,  DEATH  AND  VITAL  STATISTICS
WHICH  MAY  BE  CONTAINED IN FILES, DATABASES OR REGISTRIES, AND FOR ALL

S. 4910--A                         11

INFORMATION SHALL, UPON REQUEST, INCLUDE, WHERE POSSIBLE,  MAKING  ELEC-
TRONIC  COPIES  OR  RECORD EXCHANGES AVAILABLE. EXECUTIVE AGENCIES SHALL
COORDINATE AND FACILITATE THE  TRANSFER  OF  APPROPRIATE  FUNCTIONS  AND
POSITIONS  TO  THE OFFICE AS NECESSARY AND IN ACCORDANCE WITH APPLICABLE
LAW.
  2. UPON REQUEST OF A LOCAL SOCIAL SERVICES DISTRICT OR A PROSECUTOR OF
COMPETENT JURISDICTION, THE OFFICE,  DEPARTMENT  OF  FAMILY  ASSISTANCE,
DEPARTMENT OF HEALTH, ANY OTHER STATE OR LOCAL GOVERNMENT ENTITY AND THE
MEDICAID  FRAUD  CONTROL UNIT SHALL PROVIDE SUCH INFORMATION AND ASSIST-
ANCE AS SUCH ENTITY OR UNIT SHALL DEEM NECESSARY, APPROPRIATE AND AVAIL-
ABLE TO AID AND FACILITATE THE INVESTIGATION OF FRAUD AND  ABUSE  WITHIN
THE MEDICAL ASSISTANCE PROGRAM AND THE RECOUPMENT OF IMPROPERLY EXPENDED
FUNDS.
  S 15. Subdivision 9 of section 835 of the executive law, as amended by
section 102 of subpart B of part C and as further amended by section 104
of  part  A  of  chapter  62  of the laws of 2011, is amended to read as
follows:
  9. "Qualified agencies" means courts in the unified court system,  the
administrative  board of the judicial conference, probation departments,
sheriffs' offices, district attorneys' offices, the state department  of
corrections  and  community supervision, the department of correction of
any municipality, the insurance frauds bureau of the state department of
financial services, the office of professional medical  conduct  of  the
state department of health for the purposes of section two hundred thir-
ty  of  the  public  health law, the child protective services unit of a
local social services district when conducting an investigation pursuant
to subdivision six of section four hundred  twenty-four  of  the  social
services  law,  the  office  of  [Medicaid inspector general] THE DEPUTY
ATTORNEY GENERAL FOR MEDICAID FRAUD CONTROL, the temporary state commis-
sion of investigation, the criminal investigations bureau of the depart-
ment of financial services, police forces and departments having respon-
sibility for enforcement of the general criminal laws of the  state  and
the  Onondaga County Center for Forensic Sciences Laboratory when acting
within the scope of its law enforcement duties.
  S 16. Title 3 of article 1 of the public health law is REPEALED.
  S 17. Paragraph 3 of subsection (e) of section 697 of the tax law,  as
amended  by  chapter  206  of  the  laws  of 2011, is amended to read as
follows:
  (3) Nothing herein shall be construed to prohibit the department,  its
officers  or  employees  from  furnishing  information  to the office of
temporary and disability assistance relating to the payment of the cred-
it for certain household and dependent care services necessary for gain-
ful employment under subsection (c) of section six hundred six  of  this
article and the earned income credit under subsection (d) of section six
hundred  six of this article and the enhanced earned income credit under
subsection (d-1) of section six hundred six of this article, or pursuant
to a local law enacted by a city having a population of one  million  or
more  pursuant to subsection (f) of section thirteen hundred ten of this
chapter, only to the  extent  necessary  to  calculate  qualified  state
expenditures  under  paragraph  seven of subdivision (a) of section four
hundred nine of the federal social security act or to document the prop-
er expenditure of federal temporary assistance for needy families  funds
under  section  four  hundred three of such act. The office of temporary
and disability assistance may redisclose such information to the  United
States department of health and human services only to the extent neces-
sary  to  calculate such qualified state expenditures or to document the

S. 4910--A                         12

proper expenditure of such federal temporary assistance for needy  fami-
lies  funds.  Nothing herein shall be construed to prohibit the delivery
by the commissioner to a commissioner of jurors, appointed  pursuant  to
section  five  hundred four of the judiciary law, or, in counties within
cities having a population of one million or more, to the  county  clerk
of  such  county,  of  a  mailing list of individuals to whom income tax
forms are mailed by the commissioner for the sole purpose of compiling a
list of prospective jurors as provided in article sixteen of the judici-
ary law. Provided, however, such delivery shall only be made pursuant to
an order of the chief administrator of the courts, appointed pursuant to
section two hundred ten of the judiciary  law.  No  such  order  may  be
issued  unless  such  chief administrator is satisfied that such mailing
list is needed to compile a proper list of prospective  jurors  for  the
county for which such order is sought and that, in view of the responsi-
bilities  imposed by the various laws of the state on the department, it
is reasonable to require the commissioner to  furnish  such  list.  Such
order shall provide that such list shall be used for the sole purpose of
compiling  a  list  of  prospective jurors and that such commissioner of
jurors, or such county clerk, shall take all necessary steps  to  insure
that the list is kept confidential and that there is no unauthorized use
or  disclosure  of  such  list.  Furthermore,  nothing  herein  shall be
construed to prohibit the delivery to a taxpayer  or  his  or  her  duly
authorized  representative  of  a certified copy of any return or report
filed in connection with his or her tax or to prohibit  the  publication
of  statistics so classified as to prevent the identification of partic-
ular reports or returns and the items thereof, or the inspection by  the
attorney  general  or  other  legal  representatives of the state of the
report or return of any taxpayer or of any employer filed under  section
one  hundred  seventy-one-h  of  this  chapter,  where  such taxpayer or
employer shall bring action to set aside or review the tax based  there-
on,  or against whom an action or proceeding under this chapter or under
this chapter and article eighteen of the labor law has been  recommended
by the commissioner, the commissioner of labor with respect to unemploy-
ment  insurance matters, or the attorney general or has been instituted,
or the inspection of the reports or returns required under this  article
by  the  comptroller or duly designated officer or employee of the state
department of audit and control, for purposes of the audit of  a  refund
of  any  tax paid by a taxpayer under this article, or the furnishing to
the state department of  labor  of  unemployment  insurance  information
obtained  or derived from quarterly combined withholding, wage reporting
and unemployment insurance returns required to  be  filed  by  employers
pursuant  to  paragraph  four  of  subsection (a) of section six hundred
seventy-four of this article, for purposes  of  administration  of  such
department's   unemployment   insurance   program,  employment  services
program, federal and state employment and training programs,  employment
statistics  and  labor  market  information  programs, worker protection
programs, federal programs for which the department  has  administrative
responsibility  or  for other purposes deemed appropriate by the commis-
sioner of labor consistent with the provisions of  the  labor  law,  and
redisclosure  of  such  information in accordance with the provisions of
sections five hundred thirty-six and five hundred  thirty-seven  of  the
labor  law  or  any other applicable law, or the furnishing to the state
office of temporary and disability assistance of information obtained or
derived from New York state personal income tax returns as described  in
paragraph (b) of subdivision two of section one hundred seventy-one-g of
this chapter for the purpose of reviewing support orders enforced pursu-

S. 4910--A                         13

ant to title six-A of article three of the social services law to aid in
the  determination  of  whether  such  orders should be adjusted, or the
furnishing of information obtained  from  the  reports  required  to  be
submitted  by  employers  regarding  newly  hired  or re-hired employees
pursuant to section one hundred seventy-one-h of  this  chapter  to  the
state  office  of temporary and disability assistance, the state depart-
ment of health, the state department of labor and the  workers'  compen-
sation  board  for  purposes  of  administration  of  the  child support
enforcement program, verification of individuals' eligibility for one or
more of the programs specified  in  subsection  (b)  of  section  eleven
hundred  thirty-seven  of  the federal social security act and for other
public assistance programs authorized by state law,  and  administration
of  the  state's employment security and workers' compensation programs,
and to the national directory  of  new  hires  established  pursuant  to
section  four  hundred  fifty-three-A of the federal social security act
for the purposes specified in such section, or  the  furnishing  to  the
state  office of temporary and disability assistance of the amount of an
overpayment of income tax and interest thereon certified  to  the  comp-
troller  to be credited against past-due support pursuant to section one
hundred seventy-one-c of this chapter and of the name and social securi-
ty number of the taxpayer who made such overpayment, or  the  disclosing
to  the  commissioner  of  finance  of the city of New York, pursuant to
section one hundred seventy-one-l of this chapter, of the amount  of  an
overpayment  and  interest  thereon  certified  to the comptroller to be
credited against a city of New York tax warrant judgment debt and of the
name and social security number of the taxpayer who made  such  overpay-
ment,  or the furnishing to the New York state higher education services
corporation of the amount of an overpayment of income tax  and  interest
thereon  certified  to the comptroller to be credited against the amount
of a default in repayment of any education loan  debt,  including  judg-
ments,  owed  to  the federal or New York state government that is being
collected by the New York state higher education  services  corporation,
and of the name and social security number of the taxpayer who made such
overpayment,  or the furnishing to the state department of health of the
information required by paragraph (f) of subdivision two and subdivision
two-a of section two thousand five hundred eleven of the  public  health
law  and  by  subdivision eight of section three hundred sixty-six-a and
paragraphs (b) and (d) of  subdivision  two  of  section  three  hundred
sixty-nine-ee of the social services law, or the furnishing to the state
university  of  New York or the city university of New York respectively
or the attorney general on behalf of such state or city  university  the
amount of an overpayment of income tax and interest thereon certified to
the comptroller to be credited against the amount of a default in repay-
ment  of  a state university loan pursuant to section one hundred seven-
ty-one-e of this chapter and of the name and social security  number  of
the  taxpayer  who  made  such overpayment, or the disclosing to a state
agency, pursuant to section one hundred seventy-one-f of  this  chapter,
of  the  amount  of an overpayment and interest thereon certified to the
comptroller to be credited against a past-due legally  enforceable  debt
owed  to  such  agency and of the name and social security number of the
taxpayer who made such overpayment, or the furnishing  of  employee  and
employer  information obtained through the wage reporting system, pursu-
ant to section one hundred seventy-one-a of this chapter,  as  added  by
chapter  five  hundred forty-five of the laws of nineteen hundred seven-
ty-eight, to the state office of temporary  and  disability  assistance,
the  department  of  health  or  to  the [state] office of the [medicaid

S. 4910--A                         14

inspector general] DEPUTY ATTORNEY GENERAL FOR  MEDICAID  FRAUD  CONTROL
for  the purpose of verifying eligibility for and entitlement to amounts
of benefits under the social services law  or  similar  law  of  another
jurisdiction, locating absent parents or other persons legally responsi-
ble for the support of applicants for or recipients of public assistance
and  care  under the social services law and persons legally responsible
for the support of a recipient of services  under  section  one  hundred
eleven-g  of  the  social services law and, in appropriate cases, estab-
lishing support obligations pursuant to the social services law and  the
family court act or similar provision of law of another jurisdiction for
the  purpose  of  evaluating  the effect on earnings of participation in
employment, training or other programs designed to promote self-suffici-
ency authorized pursuant to the social services law by  current  recipi-
ents  of public assistance and care and by former applicants and recipi-
ents of public assistance and care, (except that with regard  to  former
recipients,  information  which relates to a particular former recipient
shall be provided with client identifying data deleted),  to  the  state
office  of temporary and disability assistance for the purpose of deter-
mining the eligibility of any child in the custody, care and custody  or
custody  and  guardianship of a local social services district or of the
office of children and family services for federal payments  for  foster
care and adoption assistance pursuant to the provisions of title IV-E of
the federal social security act by providing information with respect to
the  parents,  the  stepparents, the child and the siblings of the child
who were living in the same household as such  child  during  the  month
that  the  court  proceedings  leading  to  the child's removal from the
household were initiated, or the written  instrument  transferring  care
and  custody  of  the  child pursuant to the provisions of section three
hundred fifty-eight-a or  three  hundred  eighty-four-a  of  the  social
services  law  was signed, provided however that the office of temporary
and disability assistance shall only use the information obtained pursu-
ant to this subdivision for the purpose of determining  the  eligibility
of  such child for federal payments for foster care and adoption assist-
ance pursuant to the provisions of title  IV-E  of  the  federal  social
security act, and to the state department of labor, or other individuals
designated by the commissioner of labor, for the purpose of the adminis-
tration  of such department's unemployment insurance program, employment
services program, federal and state employment  and  training  programs,
employment  statistics  and  labor  market  information programs, worker
protection programs, federal  programs  for  which  the  department  has
administrative  responsibility  or for other purposes deemed appropriate
by the commissioner of labor consistent with the provisions of the labor
law, and  redisclosure  of  such  information  in  accordance  with  the
provisions  of sections five hundred thirty-six and five hundred thirty-
seven of the labor law, or  the  furnishing  of  information,  which  is
obtained from the wage reporting system operated pursuant to section one
hundred  seventy-one-a of this chapter, as added by chapter five hundred
forty-five of the laws of nineteen hundred seventy-eight, to  the  state
office  of  temporary  and  disability assistance so that it may furnish
such information to public agencies of other  jurisdictions  with  which
the state office of temporary and disability assistance has an agreement
pursuant  to paragraph (h) or (i) of subdivision three of section twenty
of the social services law, and to the state  office  of  temporary  and
disability  assistance  for  the  purpose  of fulfilling obligations and
responsibilities otherwise incumbent upon the state department of labor,
under section one hundred twenty-four of the federal family support  act

S. 4910--A                         15

of  nineteen  hundred eighty-eight, by giving the federal parent locator
service, maintained by  the  federal  department  of  health  and  human
services,  prompt access to such information as required by such act, or
to  the state department of health to verify eligibility under the child
health insurance plan pursuant to subdivisions two and two-a of  section
two  thousand  five  hundred  eleven of the public health law, to verify
eligibility under the medical assistance and family health plus programs
pursuant to subdivision eight of section three hundred  sixty-six-a  and
paragraphs  (b)  and  (d)  of  subdivision  two of section three hundred
sixty-nine-ee of the social services law, and to verify eligibility  for
the  program  for  elderly pharmaceutical insurance coverage under title
three of article two of the elder law, or to the  office  of  vocational
and educational services for individuals with disabilities of the educa-
tion  department,  the commission for the blind and visually handicapped
and any other state vocational rehabilitation agency,  for  purposes  of
obtaining  reimbursement from the federal social security administration
for expenditures made by such office, commission or agency on behalf  of
disabled  individuals  who have achieved economic self-sufficiency or to
the higher education services corporation for the purpose  of  assisting
the  corporation  in default prevention and default collection of educa-
tion loan debt, including judgments, owed to the  federal  or  New  York
state  government;  provided,  however,  that  such information shall be
limited to the names, social  security  numbers,  home  and/or  business
addresses,  and  employer  names of defaulted or delinquent student loan
borrowers, or to the office of the state  comptroller  for  purposes  of
verifying  the  income  of  a  retired  member of a retirement system or
pension plan administered by the state or any of its political  subdivi-
sions who returns to public employment.
  Provided,  however,  that  with  respect  to  employee information the
office of temporary and disability assistance shall  only  be  furnished
with the names, social security account numbers and gross wages of those
employees who are (A) applicants for or recipients of benefits under the
social services law, or similar provision of law of another jurisdiction
(pursuant  to  an agreement under subdivision three of section twenty of
the social services law) or, (B) absent parents or other persons legally
responsible for the support of applicants for or  recipients  of  public
assistance  and  care under the social services law or similar provision
of law of another jurisdiction (pursuant to an agreement under  subdivi-
sion three of section twenty of the social services law), or (C) persons
legally  responsible  for  the  support of a recipient of services under
section one hundred eleven-g of  the  social  services  law  or  similar
provision of law of another jurisdiction (pursuant to an agreement under
subdivision  three of section twenty of the social services law), or (D)
employees  about  whom  wage  reporting  system  information  is   being
furnished  to  public  agencies  of  other jurisdictions, with which the
state office of temporary and disability  assistance  has  an  agreement
pursuant  to paragraph (h) or (i) of subdivision three of section twenty
of the social services law, or (E) employees about whom  wage  reporting
system  information  is  being  furnished  to the federal parent locator
service, maintained by  the  federal  department  of  health  and  human
services,  for the purpose of enabling the state office of temporary and
disability assistance to fulfill obligations and responsibilities other-
wise incumbent upon the state department of  labor,  under  section  one
hundred  twenty-four  of  the  federal  family  support  act of nineteen
hundred eighty-eight, and, only if, the office of temporary and disabil-
ity assistance certifies to the commissioner that such persons are  such

S. 4910--A                         16

applicants,  recipients,  absent  parents or persons legally responsible
for support or persons about whom information has been  requested  by  a
public  agency  of another jurisdiction or by the federal parent locator
service  and further certifies that in the case of information requested
under agreements with  other  jurisdictions  entered  into  pursuant  to
subdivision  three  of  section  twenty of the social services law, that
such request is in compliance with any applicable federal law. Provided,
further, that where the office of temporary  and  disability  assistance
requests  employee information for the purpose of evaluating the effects
on earnings of participation in employment, training or  other  programs
designed  to  promote self-sufficiency authorized pursuant to the social
services law, the office of temporary and  disability  assistance  shall
only  be  furnished with the quarterly gross wages (excluding any refer-
ence to the name, social security number or any other information  which
could  be  used  to  identify any employee or the name or identification
number of any employer) paid to employees who are former applicants  for
or  recipients of public assistance and care and who are so certified to
the commissioner by the commissioner of  the  office  of  temporary  and
disability  assistance. Provided, further, that with respect to employee
information, the department of health shall only be furnished  with  the
information  required  pursuant  to  the  provisions of paragraph (f) of
subdivision two and subdivision  two-a  of  section  two  thousand  five
hundred eleven of the public health law and subdivision eight of section
three  hundred sixty-six-a and paragraphs (b) and (d) of subdivision two
of section three hundred sixty-nine-ee of the social services law,  with
respect  to  those  individuals whose eligibility under the child health
insurance plan, medical  assistance  program,  and  family  health  plus
program is to be determined pursuant to such provisions and with respect
to those members of any such individual's household whose income affects
such  individual's  eligibility  and who are so certified to the commis-
sioner or by the department of  health.  Provided,  further,  that  wage
reporting information shall be furnished to the office of vocational and
educational  services for individuals with disabilities of the education
department, the commission for the blind and  visually  handicapped  and
any  other  state  vocational rehabilitation agency only if such office,
commission or agency, as applicable, certifies to the commissioner  that
such  information  is necessary to obtain reimbursement from the federal
social security administration for expenditures made on behalf of  disa-
bled individuals who have achieved self-sufficiency. Reports and returns
shall be preserved for three years and thereafter until the commissioner
orders them to be destroyed.
  S  18.  Subdivision  1  of  section  190  of the state finance law, as
amended by chapter 379 of the laws  of  2010,  is  amended  to  read  as
follows:
  1.  Civil  enforcement  actions.  The  attorney general shall have the
authority to investigate violations under section  one  hundred  eighty-
nine of this article. If the attorney general believes that a person has
violated  or  is  violating  such section, then the attorney general may
bring a civil action on behalf of the people of the state of New York or
on behalf of a local government against such person. A local  government
also  shall  have  the authority to investigate violations that may have
resulted in damages to such local government under section  one  hundred
eighty-nine  of  this  article,  and may bring a civil action on its own
behalf, or on behalf of any subdivision of  such  local  government,  to
recover  damages  sustained by such local government as a result of such
violations. No action may be filed pursuant to this subdivision  against

S. 4910--A                         17

the  federal government, the state or a local government, or any officer
or employee thereof acting in his or her official capacity. The attorney
general shall consult with the office of  [medicaid  inspector  general]
THE  DEPUTY  ATTORNEY GENERAL FOR MEDICAID FRAUD CONTROL prior to filing
any action related to the medicaid program.
  S 19. The closing paragraph of  paragraph  (b)  of  subdivision  2  of
section  190  of the state finance law, as amended by chapter 379 of the
laws of 2010, is amended to read as follows:
  The state may elect to supersede or intervene  and  proceed  with  the
action,  or  to  authorize  a  local  government that may have sustained
damages to supersede or intervene, within sixty days after  it  receives
both  the complaint and the material evidence and information; provided,
however, that if the allegations in the complaint involve  damages  only
to  a  city  with a population of one million or more, then the attorney
general may not supersede  or  intervene  in  such  action  without  the
consent  of  the  corporation counsel of such city. The attorney general
shall consult with the office of the [medicaid inspector general] DEPUTY
ATTORNEY GENERAL FOR MEDICAID FRAUD  CONTROL  prior  to  superseding  or
intervening  in any action related to the medicaid program. The attorney
general may, for good cause shown, move the court for extensions of  the
time  during  which the complaint remains under seal under this subdivi-
sion.  Any  such  motions  may  be  supported  by  affidavits  or  other
submissions in camera.
  S  20.    Paragraph  (c)  of subdivision 5 of section 190 of the state
finance law, as added by section 39 of part C of chapter 58 of the  laws
of 2007, is amended to read as follows:
  (c)  Notwithstanding  any  other  provision of law, whether or not the
attorney general or a local government elects to supersede or  intervene
in  a  qui tam civil action, the attorney general and such local govern-
ment may elect to pursue any remedy available with respect to the crimi-
nal or civil prosecution of the presentation of false claims,  including
any  administrative  proceeding to determine a civil money penalty or to
refer the matter to the office of the [medicaid inspector general] DEPU-
TY ATTORNEY GENERAL FOR MEDICAID  FRAUD  CONTROL  for  medicaid  related
matters.  If  any  such  alternate  civil  remedy  is pursued in another
proceeding, the person initiating the action shall have the same  rights
in  such  proceeding  as  such  person  would have had if the action had
continued under this section.
  S 21. Subdivision 2 of section 23 of the social services law, as added
by chapter 545 of the laws of 1978, is amended to read as follows:
  2. Notwithstanding any law  to  the  contrary,  the  department,  upon
request by the office of [welfare inspector general] THE DEPUTY ATTORNEY
GENERAL  FOR MEDICAID FRAUD CONTROL, shall provide said office with such
information it receives from the wage reporting system operated  by  the
department of taxation and finance that the office of [welfare inspector
general]  THE  DEPUTY  ATTORNEY GENERAL FOR MEDICAID FRAUD CONTROL deems
necessary to carry out its functions and  duties  under  article  [four]
FIVE of the executive law.
  S  22.  Subdivision  2  of  section 136 of the social services law, as
amended by section 24 of part B of chapter 436 of the laws of  1997,  is
amended to read as follows:
  2.  All  communications and information relating to a person receiving
public assistance or care obtained  by  any  social  services  official,
service  officer,  or employee in the course of his or her work shall be
considered confidential  and,  except  as  otherwise  provided  in  this
section,  shall  be  disclosed  only  to the commissioner, or his or her

S. 4910--A                         18

authorized representative, the commissioner of labor, or    his  or  her
authorized  representative,  the  commissioner  of health, or his or her
authorized representative, the [welfare inspector general] DEPUTY ATTOR-
NEY  GENERAL FOR MEDICAID FRAUD CONTROL, or his or her authorized repre-
sentative, the county  board of supervisors, city council, town board or
other board or body authorized and required  to  appropriate  funds  for
public  assistance  and care in and for such county, city or town or its
authorized representative or, by authority of the county, city  or  town
social  services  official, to a person or agency considered entitled to
such information. Nothing herein shall preclude  a      social  services
official  from reporting to an appropriate agency or official, including
law enforcement agencies or officials, known or  suspected instances  of
physical  or mental injury, sexual abuse or exploitation, sexual contact
with a minor or negligent treatment or maltreatment of a child of  which
the  official  becomes  aware in the administration of public assistance
and care nor shall it preclude  communication  with  the  federal  immi-
gration  and  naturalization service regarding the immigration status of
any individual.
  S 23. Subdivisions 2 and 5 of section 145-b  of  the  social  services
law,  as amended by chapter 109 of the laws of 2007, are amended to read
as follows:
  2. For any violation of subdivision one OF  THIS  SECTION,  the  local
social  services  district  or  the  state shall have a right to recover
civil damages equal to three times the amount by  which  any  figure  is
falsely  overstated  or  in the case of non-monetary false statements or
representations, three times the amount  of  damages  which  the  state,
political  subdivision of the state, or entity performing services under
contract to the state or political subdivision of the state sustain as a
result of the violation or five thousand dollars, whichever is  greater.
Notwithstanding  part  C of chapter fifty-eight of the laws of two thou-
sand five: (a) For civil damages collected by a  local  social  services
district,  relating  to  the  medical  assistance program, pursuant to a
judgment under this  subdivision,  such  amounts  shall  be  apportioned
between  the  local  social  services  district  and  the  state. If the
violation occurred: (i) prior to January first, two  thousand  six,  the
amount  apportioned  to  the local social services district shall be the
local share percentage in effect  immediately  prior  to  such  date  as
certified  by  the  division of budget, or (ii) after January first, two
thousand six, the  amount  apportioned  to  the  local  social  services
district  shall  be  based  on  a reimbursement schedule, created by the
office of [Medicaid inspector general] THE DEPUTY ATTORNEY  GENERAL  FOR
MEDICAID  FRAUD  CONTROL,  in effect at the time the violation occurred;
provided that, if there is  no  schedule  in  effect  at  the  time  the
violation  occurred, the schedule to be used shall be the first schedule
adopted pursuant to this subdivision. Such schedule  shall  provide  for
reimbursement  to  a local social services district in an amount between
ten and fifteen percent of the gross  amount  collected.  Such  schedule
shall  be  set  on  a  county  by county basis and shall be periodically
reviewed and updated as necessary;  provided,  however,  that  any  such
updated  schedule  shall  not  be less than ten percent nor greater than
fifteen percent of the gross amount collected; and (b) For civil damages
collected by the state relating to the medical assistance program pursu-
ant to a judgment under this  subdivision,  the  local  social  services
district  shall be entitled to compensation up to fifteen percent of the
gross amount collected for such participation, including but not limited
to identification, investigation or development of a case,  commensurate

S. 4910--A                         19

with  its  level of effort or value added as determined by the [Medicaid
inspector general] DEPUTY ATTORNEY GENERAL FOR MEDICAID FRAUD CONTROL.
  5.  When  in the course of conducting an investigation relating to the
investigation relating to the medical assistance program, a local social
services district deduces that a provider may  have  committed  criminal
fraud,  it  shall  refer  the  case to the office of [Medicaid inspector
general] DEPUTY ATTORNEY GENERAL FOR MEDICAID FRAUD CONTROL  along  with
appropriate supporting information. The office shall promptly review the
case [and, if deemed appropriate, refer the case pursuant to subdivision
seven  of  section  thirty-two  of the public health law]. If the deputy
attorney general for [Medicaid] MEDICAID fraud control [accepts]  PROSE-
CUTES  a  [referral  from the office of Medicaid inspector general] CASE
that was  identified,  investigated  or  developed  by  a  local  social
services  district,  and  the  state collects damages, the participating
local social services district shall be entitled to compensation  up  to
fifteen  percent  of  the  gross amount collected for such participation
commensurate with its level of effort or value added  as  determined  by
the  deputy  attorney  general for [Medicaid] MEDICAID fraud control. If
the office of [Medicaid inspector general] THE DEPUTY  ATTORNEY  GENERAL
FOR  MEDICAID  FRAUD  CONTROL  determines that it is not appropriate for
[referral in accordance with subdivision seven of section thirty-two  of
the  public  health  law]  PROSECUTION the office of [Medicaid inspector
general] THE DEPUTY ATTORNEY GENERAL FOR MEDICAID  FRAUD  CONTROL  shall
further  investigate  the  case,  with notice to the participating local
social services district, or return the case to the participating social
services district, which may resume its investigation of the provider.
  S 24. The opening paragraph of subdivision 2, the opening paragraph of
subdivision 3 and subdivision 4 of section 363-d of the social  services
law,  the  opening paragraph of subdivision 2 and subdivision 4 as added
by chapter 442 of the laws of 2006 and the opening paragraph of subdivi-
sion 3 as amended by section 44 of part C of chapter 58 of the  laws  of
2007, are amended to read as follows:
  Every  provider  of medical assistance program items and services that
is subject to subdivision four of this section shall adopt and implement
a compliance program. The office of  [Medicaid  inspector  general]  THE
DEPUTY ATTORNEY GENERAL FOR MEDICAID FRAUD CONTROL shall create and make
available  on  its website guidelines, which may include a model compli-
ance program, that reflect the  requirements  of  this  section.    Such
program  shall  at  a  minimum be applicable to billings to and payments
from the medical assistance program but need not  be  confined  to  such
matters. The compliance program required pursuant to this section may be
a  component  of more comprehensive compliance activities by the medical
assistance provider so long as the requirements of this section are met.
A compliance program shall include the following elements:
  Upon enrollment in the medical assistance program,  a  provider  shall
certify  to  the  department  that the provider satisfactorily meets the
requirements of this section. Additionally, the commissioner  of  health
and  [Medicaid  inspector general] THE DEPUTY ATTORNEY GENERAL FOR MEDI-
CAID FRAUD CONTROL shall have the authority to determine at any time  if
a  provider  has  a  compliance  program  that  satisfactorily meets the
requirements of this section.
  4. The [Medicaid inspector general] DEPUTY ATTORNEY GENERAL FOR  MEDI-
CAID FRAUD CONTROL, in consultation with the department of health, shall
promulgate  regulations  establishing  those  providers  that  shall  be
subject to the provisions of this section including, but not limited to,
those subject to the provisions of articles twenty-eight and  thirty-six

S. 4910--A                         20

of  the public health law, articles sixteen and thirty-one of the mental
hygiene law, and other providers of care, services  and  supplies  under
the  medical assistance program for which the medical assistance program
is a substantial portion of their business operations.
  S  25.  Paragraph  (c) of subdivision 1 of section 365-j of the social
services law, as added by chapter 442 of the laws of 2006, is amended to
read as follows:
  (c) An advisory opinion will not be issued where the petition  for  an
advisory opinion relates to a pending question raised by the provider in
an ongoing or initiated investigation conducted by the [Medicaid inspec-
tor  general,] deputy attorney general for [the Medicaid] MEDICAID fraud
[unit,] CONTROL or any other criminal  investigation  or  any  civil  or
criminal  proceeding,  or  where  the  provider has received any written
notice of the commissioner or the [Medicaid  inspector  general]  DEPUTY
ATTORNEY  GENERAL FOR MEDICAID FRAUD CONTROL which advises a provider of
an imminent investigation, audit, pended or otherwise  suspended  claim,
or withhold of payment or reimbursement.
  S  26.  Paragraph  (e) of subdivision 5 of section 366-a of the social
services law, as added by section 1 of part C of chapter 58 of the  laws
of 2007, is amended to read as follows:
  (e) The commissioner of health shall verify the accuracy of the infor-
mation  provided  by  the  recipient  pursuant  to paragraph (d) of this
subdivision by matching it against information to which the commissioner
of health has access, including under subdivision eight of this section.
In the event there is an inconsistency between the information  reported
by  the  recipient  and  any information obtained by the commissioner of
health from other sources and such inconsistency is material to  medical
assistance  eligibility,  the  commissioner of health shall request that
the recipient provide adequate documentation to verify his or her  place
of  residence or income, as applicable. In addition to the documentation
of residence and income authorized by this paragraph,  the  commissioner
of  health  is authorized to periodically require a reasonable sample of
recipients to provide documentation of residence and income at recertif-
ication. The commissioner of health shall  consult  with  the  [medicaid
inspector  general]  DEPUTY  ATTORNEY GENERAL FOR MEDICAID FRAUD CONTROL
regarding income and residence  verification  practices  and  procedures
necessary to maintain program integrity and deter fraud and abuse.
  S  27.   Subdivision 8 of section 367-b of the social services law, as
amended by chapter 442 of the laws of 2006, paragraphs (a)  and  (b)  as
amended  by  chapter  109  of  the  laws  of 2007, is amended to read as
follows:
  8. (a) For the purpose of orderly and  timely  implementation  of  the
medical  assistance  information  and  payment system, the department is
hereby authorized to enter into agreements with fiscal intermediaries or
fiscal agents for the design,  development,  implementation,  operation,
processing,  auditing  and  making  of payments, subject to audits being
conducted by the state in accordance with the terms of such  agreements,
for medical assistance claims under the system described by this section
in  any  social  services  district.  Such agreements shall specifically
provide that the state shall have complete oversight responsibility  for
the  fiscal  intermediaries'  or fiscal agents' performance and shall be
solely responsible for establishing eligibility requirements for recipi-
ents,  provider  qualifications,  rates  of  payment,  investigation  of
suspected  fraud and abuse, issuance of identification cards, establish-
ing and maintaining recipient eligibility files, provider profiles,  and
conducting  state  audits  of  the  fiscal intermediaries' or agents' at

S. 4910--A                         21

least once annually. The system described in this subdivision  shall  be
operated  by  a  fiscal  intermediary or fiscal agent in accordance with
this subdivision unless the department is otherwise authorized by a  law
enacted  subsequent to the effective date of this subdivision to operate
the system in another manner. In no event  shall  such  intermediary  or
agent  be a political subdivision of the state or any other governmental
agency or entity. The department shall consult with the office of [Medi-
caid inspector general] THE DEPUTY ATTORNEY GENERAL FOR  MEDICAID  FRAUD
CONTROL regarding any activities undertaken by the fiscal intermediaries
or fiscal agents regarding investigation of suspected fraud and abuse.
  (b)  The  department  of  health,  in  consultation with the office of
[Medicaid inspector general] THE DEPUTY ATTORNEY  GENERAL  FOR  MEDICAID
FRAUD  CONTROL,  shall  develop,  test  and  implement  new  methods  to
strengthen the capability of  the  medical  assistance  information  and
payment  system  to  detect  and  control  fraud and improve expenditure
accountability, and is hereby authorized to enter  into  further  agree-
ments  with fiscal and/or information technology agents for the develop-
ment, testing and implementation of such new methods.  Any  such  agree-
ments  shall  be  with  agents  which have demonstrated expertise in the
areas addressed by the agreement. Such  methods  shall,  at  a  minimum,
address the following areas:
  (1) Prepayment claims review. Develop, test and implement an automated
claims  review  process  which,  prior to payment, shall subject medical
assistance program services claims to review for proper coding and  such
other  review  as  may  be  deemed necessary. Services subject to review
shall be based on: the expected  cost-effectiveness  of  reviewing  such
service;  the capabilities of the automated system for conducting such a
review; and the potential  to  implement  such  review  with  negligible
effect  on the turnaround of claims for provider payment or on recipient
access to necessary services.  Such  initiative  shall  be  designed  to
provide for the efficient and effective operation of the medical assist-
ance  program  claims  payment system by performing functions including,
but not limited to, capturing coding errors, misjudgments, incorrect  or
multiple  billing  for the same service and possible excesses in billing
or service use, whether intentional or unintentional.
  (2) Coordination of benefits. Develop, test and implement an automated
process to improve the coordination  of  benefits  between  the  medical
assistance  program and other sources of coverage for medical assistance
recipients. Such initiative shall initially examine the  savings  poten-
tial  to  the medical assistance program through retrospective review of
claims paid which shall be completed  not  later  than  January  thirty-
first,  two  thousand seven. If, based upon such initial experience, the
[Medicaid inspector general] DEPUTY ATTORNEY GENERAL FOR MEDICAID  FRAUD
CONTROL deems the automated process to be capable of including or moving
to  a  prospective  review,  with negligible effect on the turnaround of
claims for provider payment or on recipient access to services, then the
[Medicaid inspector general] DEPUTY ATTORNEY GENERAL FOR MEDICAID  FRAUD
CONTROL  in subsequent tests shall examine the savings potential through
prospective, pre-claims payment review.
  (3) Comprehensive review of  paid  claims.  Take  all  reasonable  and
necessary  actions to intensify the state's current level of monitoring,
analyzing, reporting and responding to medical assistance program claims
data maintained  by  the  state's  medical  assistance  information  and
payment system contract agents. Pursuant to this initiative, the depart-
ment  of health, in collaboration with the office of [Medicaid inspector
general] THE DEPUTY ATTORNEY GENERAL FOR MEDICAID FRAUD  CONTROL,  shall

S. 4910--A                         22

make  efforts to improve the utilization of such data in order to better
identify fraud and abuse within the medical assistance  program  and  to
identify  and implement further program and patient care reforms for the
improvement  of  such program. In addition, the department of health, in
consultation with such contract  agents  and  the  office  of  [Medicaid
inspector  general]  THE  DEPUTY  ATTORNEY  GENERAL  FOR  MEDICAID FRAUD
CONTROL, shall identify additional data elements that are maintained and
otherwise accessible by the  state,  directly  or  through  any  of  its
contractors,  that  would,  if coordinated with medical assistance data,
further increase the effectiveness of data analysis for  the  management
of  the  medical  assistance  program. To further the objectives of this
subparagraph, the department of health, in collaboration with the office
of [Medicaid inspector general] THE DEPUTY ATTORNEY GENERAL FOR MEDICAID
FRAUD CONTROL, shall provide or arrange in-service  training  for  state
and  county  medical assistance personnel to increase the capability for
state and local data analysis, leading to a more  cost-effective  opera-
tion of the medical assistance program.
  (4)  Targeted  claims and utilization review. Develop, test and imple-
ment an automated process for the targeted review  of  claims,  services
and/or  populations  not  later  than January thirty-first, two thousand
seven.  Such review shall be for the purposes of identifying statistical
aberrations in the use or billing of such services and for assisting  in
the  development  and  implementation of measures to ensure that service
use and billing are appropriate to recipients' needs.
  (c) The commissioner of health shall prepare  and  submit  an  interim
report  to  the  governor  and  legislature on the implementation of the
initiatives specified in paragraph (b) of this subdivision no later than
December first, two thousand  seven.  Such  report  shall  also  include
recommendations  for  any  revisions  that  would further facilitate the
goals of such paragraph, including  recommendations  for  expansion.  In
addition,  the  commissioner  of  health shall submit a final report not
later than December first, two thousand eight. In preparing such interim
and final reports, the commissioner of health  shall  consult  with  the
[Medicaid  inspector general] DEPUTY ATTORNEY GENERAL FOR MEDICAID FRAUD
CONTROL, third-party agents, providers and  recipients  associated  with
the implementation of paragraph (b) of this subdivision.
  S  28.  Paragraph (d) of subdivision 2 of section 369-ee of the social
services law, as added by section 1-c of part C of  chapter  58  of  the
laws of 2007, is amended to read as follows:
  (d)  In  order  to establish place of residence and income eligibility
under this title at recertification, a  recipient  of  assistance  under
this  title  shall  attest  to place of residence and to all information
regarding the household's income that is  necessary  and  sufficient  to
determine  such eligibility. The commissioner of health shall verify the
accuracy of the information provided by the recipient pursuant  to  this
paragraph  by  matching it against information to which the commissioner
of health has access, including under subdivision eight of section three
hundred sixty-six-a of this article. In the event there is an inconsist-
ency between the information reported by the recipient and any  informa-
tion  obtained by the commissioner of health from other sources and such
inconsistency is material to eligibility under this title,  the  commis-
sioner  of  health  shall  request  that  the recipient provide adequate
documentation to verify his or her place  of  residence  or  income,  as
applicable.  In  addition  to  the documentation of residence and income
authorized by this paragraph, the commissioner of health  is  authorized
to  periodically  require  a  reasonable sample of recipients to provide

S. 4910--A                         23

documentation of residence and income at  recertification.  The  commis-
sioner  of  health  shall  consult with the [medicaid inspector general]
DEPUTY ATTORNEY GENERAL FOR MEDICAID FRAUD CONTROL regarding income  and
residence  verification  practices  and procedures necessary to maintain
program integrity and deter fraud and abuse.
  S 29. The office of the welfare inspector general and  the  office  of
the  medicaid  inspector  general  are abolished. When the term "welfare
inspector general" or "medicaid inspector general",  or  any  equivalent
expression  thereof  is  used in any provision of law, contract or docu-
ment, such office shall be deemed to mean and refer to the deputy attor-
ney general for medicaid fraud control.
  S 30. All of the functions and powers possessed  by  and  all  of  the
obligations  and  duties  of the office of the welfare inspector general
and the office of the medicaid inspector  general  are  transferred  and
assigned  to,  assumed  by  and  devolved  upon the office of the deputy
attorney general for medicaid fraud control.
  S 31. The welfare inspector general and the medicaid inspector general
shall deliver to the deputy attorney general for medicaid fraud  control
all  books, papers, records, decisions and property of the office of the
welfare inspector general and  the  office  of  the  medicaid  inspector
general.
  S  32.  For the purpose of succession to all duties, functions, powers
and obligations transferred and assigned to, devolved upon  and  assumed
by the office of the deputy attorney general for medicaid fraud control,
such  office  shall be deemed and held to constitute the continuation of
the office of the welfare inspector general and the office of the  medi-
caid inspector general.
  S  33.  All  federal appropriations made to the office of the medicaid
inspector are hereby transferred  to  the  department  of  law  for  the
purposes of the office of the deputy attorney general for medicaid fraud
control.
  S 34. This act shall take effect on the first of October next succeed-
ing the date on which it shall have become a law.