S T A T E   O F   N E W   Y O R K
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                                  5113

                       2015-2016 Regular Sessions

                          I N  A S S E M B L Y

                            February 12, 2015
                               ___________

Introduced  by M. of A. GOODELL -- read once and referred to the Commit-
  tee on Health

AN ACT to amend the social services law, in relation to creating  incen-
  tives for counties to investigate and prosecute medicaid fraud

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

  Section 1. The social services law is amended by adding a new  article
5-A to read as follows:
                                ARTICLE 5-A
                      MEDICAID FRAUD REIMBURSEMENT
SECTION 370-BB. DISPOSITION  OF  MONEYS  RECEIVED  AS  THE RESULT OF THE
                  PROSECUTION OF MEDICAID FRAUD.
  S 370-BB. DISPOSITION OF MONEYS RECEIVED AS THE RESULT OF  THE  PROSE-
CUTION OF MEDICAID FRAUD. 1. FOR THE PURPOSES OF THIS SECTION, "MEDICAID
FRAUD"  SHALL  MEAN  THE  KNOWING COMMISSION OF ANY CRIME WITH INTENT TO
ILLEGALLY RECEIVE BENEFITS, OR REIMBURSEMENT FROM THE MEDICAL ASSISTANCE
FOR NEEDY PERSONS PROGRAM ESTABLISHED AND ADMINISTERED PURSUANT TO  THIS
CHAPTER, THE PUBLIC HEALTH LAW AND FEDERAL LAW.
  2.  SHOULD  ANY  COUNTY OR THE CITY OF NEW YORK SUCCESSFULLY PROSECUTE
ANY CASE FOR MEDICAID FRAUD AND A  COURT  AWARDS  RESTITUTION  OR  CIVIL
FORFEITURE,  THE  FOLLOWING  PORTION  OF  THE  NON-FEDERAL  SHARE OF THE
PROCEEDS OF SUCH RESTITUTION OR CIVIL FORFEITURE SHALL BE  ALLOCATED  AS
FOLLOWS:
  (I)  THE  COUNTY  OR  THE  CITY  OF NEW YORK SHALL RECEIVE ONE HUNDRED
PERCENT OF THE LOCAL SHARE OF SUCH FUNDS, IN EFFECT IMMEDIATELY PRIOR TO
SUCH DATE AS CERTIFIED BY THE DIVISION OF BUDGET OR TEN PERCENT  OF  THE
TOTAL RECOVERY WHICHEVER NUMBER IS GREATER; AND
  (II) THE REMAINDER THEREOF SHALL BE DEPOSITED INTO THE GENERAL FUND OF
THE STATE.

 EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                      [ ] is old law to be omitted.
                                                           LBD05985-01-5

A. 5113                             2
              

  3.  NOTHING IN THIS ARTICLE SHALL IMPAIR ANY COUNTY OR THE CITY OF NEW
YORK'S ABILITY TO SEEK DAMAGES UNDER SECTION ONE HUNDRED FORTY-FIVE-B OF
THIS CHAPTER.
  S  2.  Paragraph  (a)  of subdivision 2 of section 145-b of the social
services law, as amended by chapter 109 of the laws of 2007, is  amended
to read as follows:
  (a)  For  civil damages collected by a local social services district,
relating to the medical assistance program, pursuant to  a  judgment  OR
SETTLEMENT  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]
THE amount apportioned to the local social services  district  shall  be
ONE  HUNDRED  PERCENT  OF the local share [percentage] OF SUCH FUNDS, 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, 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 neces-
sary; provided, however, that any such updated  schedule  shall  not  be
less  than  ten  percent  nor  greater than fifteen percent of the gross
amount collected] OR TEN PERCENT OF THE TOTAL RECOVERY WHICHEVER  NUMBER
IS GREATER; and
  S 3. This act shall take effect immediately.