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Senate Bill S2554

2013-2014 Legislative Session

Relates to enforcement actions by the office of the Medicaid inspector general

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Archive: Last Bill Status - In Senate Committee Health Committee

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2013-S2554 (ACTIVE) - Details

Current Committee:
Senate Health
Law Section:
Public Health Law
Laws Affected:
Amd ยง32, Pub Health L
Versions Introduced in 2011-2012 Legislative Session:
S4806

2013-S2554 (ACTIVE) - Summary

Relates to enforcement actions by the office of the Medicaid inspector general.

2013-S2554 (ACTIVE) - Sponsor Memo

2013-S2554 (ACTIVE) - Bill Text download pdf 

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

                                  2554

                       2013-2014 Regular Sessions

                            I N  S E N A T E

                            January 22, 2013
                               ___________

Introduced  by  Sen.  MARCELLINO  -- read twice and ordered printed, and
  when printed to be committed to the Committee on Health

AN ACT to amend the  public  health  law,  in  relation  to  enforcement
  actions by 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. Subdivision 6 of section 32 of the public  health  law,  as
added by chapter 442 of the laws of 2006, is amended to read as follows:
  6.  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 medical assist-
ance program, including but not limited to: (a) referral of  information
and  evidence to regulatory agencies and licensure boards; (b) withhold-
ing payment of medical assistance funds in  accordance  with  state  and
federal laws and regulations; (c) imposition of administrative sanctions
and penalties in 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  recov-
ery  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 medical assistance program funds
from  those  who  engage  in fraud or abuse, or illegal or improper acts
perpetrated within the medical assistance program.  THE INSPECTOR  SHALL
NOT  APPLY  ANY  EXTRAPOLATION  METHOD  TO A CATEGORY OF ERROR OR DEFECT
WITHIN A SAMPLE UNLESS THE INSPECTOR  SHALL  FIRST  DETERMINE  THAT  THE
CATEGORY  OF ERROR OR DEFECT IN THE BILLING OR OTHER PRACTICE IDENTIFIED
BY THE INSPECTOR IN THE SAMPLE OF CLAIMS EXCEEDS A RATE OF FIVE  PERCENT
WITHIN  THE  SAMPLE OF CLAIMS. In the pursuit of such civil and adminis-
trative enforcement actions under this subdivision, the inspector  shall
consider  the  quality and availability of medical care and services and
the best interest of both the medical assistance program and recipients;
  S 2. This act shall take effect on the first of January next  succeed-
ing  the  date  upon which it shall have become a law and shall apply to
enforcement actions commenced on or after such date.

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