S T A T E O F N E W Y O R K
________________________________________________________________________
4880
2021-2022 Regular Sessions
I N A S S E M B L Y
February 8, 2021
___________
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.
§ 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.
LBD09019-01-1
A. 4880 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.
§ 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
§ 3. This act shall take effect immediately.