Assemblywoman Michele R. Titus (D-Queens) was appointed by Speaker Sheldon Silver to an Assembly/Senate joint taskforce to combat Medicaid fraud, including the creation of a Medicaid Inspector General and stricter penalties for offenders (A.12015).
“Medicaid fraud not only wastes taxpayer dollars, it robs our most vulnerable – the sick, disabled and elderly – of the care they need,” Assemblywoman Titus said. “Cracking down on Medicaid fraud will help protect people in need of care as well as taxpayers by punishing those who intentionally defraud the health care plan.”
Assemblywoman Titus noted that the Assembly’s call for a conference committee was essential in getting the Senate to negotiate in the light of day and reach an agreement on this vital issue.
Increasing accountability through a Medicaid Inspector General
The Legislature agreed to create the Office of Medicaid Inspector General to uncover and combat fraud and abuse in the state’s Medicaid system. Responsibilities of the office include Medicaid auditing and fraud and abuse prevention. The Medicaid Inspector General will be appointed by, and serve at the pleasure of, the governor.
“The Medicaid Inspector General will be charged with rooting out improperly paid claims that may or may not have been submitted fraudulently,” Assemblywoman Titus said. “Through these audits, millions of taxpayer dollars will be recovered. And by implementing stronger oversight, criminals will be caught and further attempts to commit fraud will be deterred.”
Agreement strengthens criminal penalties for Medicaid fraud
The legislative agreement also creates five new crimes, including four felonies, to fight Medicaid fraud and help prosecutors do their jobs. These health care fraud offenses include corresponding fines and penalties that range from up to a year in jail to up to 25 years in prison.
“Medicaid fraud is a crime against taxpayers – plain and simple,” Assemblywoman Titus said. “We must provide stronger penalties for fraud. The current laws are inadequate to combat those who scam the Medicaid system. The legislative agreement establishes new health care fraud penalties to send a strong message that stealing health care dollars will not be tolerated.”
Senate refuses to help state recover stolen Medicaid dollars in “false claims”
Assemblywoman Titus added that the measure is not as effective as it could be because the Senate refused to agree to a false claims provision, which would allow private citizens to bring a civil suit and share a portion of the money recovered.
“The false claims provision the Assembly pushed for has widespread bipartisan support,” Assemblywoman Titus said. “It’s based on the federal False Claims Act, which has served as a model for 15 other states. And according to the U.S. Department of Justice, $1.4 billion was recovered under the False Claims Act last year, including $1.1 billion in Medicaid fraud cases.”
Assemblywoman Titus noted that the Pataki administration, according to a newly released federal review, has failed to adequately combat Medicaid fraud and waste in New York State. In fact, the level of state staffing assigned to Medicaid anti-fraud work has been slashed by more than 60 percent – from 950 in 1998 to 584 in 2004, according to the Centers for Medicare and Medicaid Services.
“Fraud is a damaging, corrosive problem within the Medicaid system – but one that can be battled with the right legislation,” Assemblywoman Titus said. “The Pataki administration has failed to address this important issue. I urge the governor to finally join the Legislature in our fight against Medicaid fraud and help us eliminate this costly burden on taxpayers and our health care system.”