A. 8388--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,
A. 8388--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-
A. 8388--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.
A. 8388--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.
A. 8388--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
A. 8388--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.
A. 8388--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
A. 8388--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;
A. 8388--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
A. 8388--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
A. 8388--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-
A. 8388--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
A. 8388--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
A. 8388--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
A. 8388--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
A. 8388--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
A. 8388--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
A. 8388--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
A. 8388--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
A. 8388--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
A. 8388--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
A. 8388--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.