Waste &
Abuse Cost
More Than
$4.5 Billion Annually!

Assemblyman Michael Fitzpatrick Assemblyman Michael Fitzpatrick:
Strengthening Suffolk County’s Fight Against Medicaid Waste, Fraud and Abuse

Assemblyman Michael Fitzpatrick is sponsoring the Medicaid Fraud Prevention and Recovery Reform Act of 2006 – to stop Medicaid waste and save New Yorkers approximately $4.5 billion each year.

The legislation would allow state and local law enforcement to boost Medicaid compliance, investigate program waste and fraud, recoup funds and impose sanctions on violators.

The legislation would:

  • Create the Office of Medicaid Inspector General to focus on program compliance, fraud investigations, recouping funds and establishing harsher penalties for offenders.

  • Allow counties to investigate fraud to expedite and facilitate criminal prosecutions.

  • Restore local shares of certain Medicaid fraud recoveries. County and district attorney offices would receive 15 percent of the nonfederal shares of restitution or recovered funds.

  • Improve technology to better detect Medicaid fraud, conduct utilization reviews and coordinate third-party benefits, thereby providing greater accountability of Medicaid expenditures. Improved technology would cross-reference databases to detect fraud at the beginning of the filing cycle, thus saving taxpayer money immediately while improving the current system used by the state, notoriously known as “pay and chase.”

  • Create a Corporate Compliance Program requiring larger Medicaid providers to implement corporate compliance software and internal control programs designed to prevent improper and inaccurate billings and fraud.

According to a July 18, 2005
New York Times article. . .

New York’s Medicaid program has become a target for unscrupulous and opportunistic criminals. It’s believed up to 40 percent, or $18 billion per year, of Medicaid claims are questionable.

New York’s $44.5 billion annual Medicaid program is the largest and most expensive in the nation, larger than Texas and Florida combined.

And it continues to grow. Meanwhile, Albany continues to cut the state’s ability to police Medicaid fraud, waste and abuse.

New York was once near the top in Medicaid fraud investigation efficiency; it now ranks at the bottom. In the late 1980s, 200 employees were assigned to police Medicaid fraud; there are about 50 today. As a result, only 37 Medicaid fraud cases were referred to prosecutors last year, 220 fewer than in Texas, a state that spends less than half as New York on Medicaid.

“Continued abuse of Medicaid will result in higher property taxes for Suffolk County property owners. Albany must work harder to protect taxpayer money.”

— Assemblyman Michael Fitzpatrick

Contact Assemblyman Michael Fitzpatrick
50 Route 111 • Suite 202 • Smithtown, NY 11787 • (631) 724-2929