Relates to the handling of tips received through the office of the Medicaid inspector general's Medicaid fraud hotline; provides that the office of the Medicaid inspector general's Medicaid fraud hotline shall be the official Medicaid fraud hotline of the state of New York; directs the Medicaid inspector general to compile and provide to the governor, the temporary president of the senate, the speaker of the assembly, the minority leader of the senate, the minority leader of the assembly and the attorney general an annual report containing information on tips received through the Medicaid fraud hotline.
STATE OF NEW YORK
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11731
IN ASSEMBLY
September 16, 2026
___________
Introduced by COMMITTEE ON RULES -- (at request of M. of A. DeStefano)
-- read once and referred to the Committee on Health
AN ACT to amend the public health law, in relation to the handling of
tips received through the office of the Medicaid inspector general's
Medicaid fraud hotline
The People of the State of New York, represented in Senate and Assem-bly, do enact as follows:
1 Section 1. Subdivisions 4, 5 and 7 of section 32 of the public health
2 law, subdivisions 4 and 7 as added by chapter 442 of the laws of 2006
3 and subdivision 5 as amended by section 110 of part E of chapter 56 of
4 the laws of 2013, are amended to read as follows:
5 4. to solicit, receive and investigate complaints related to fraud and
6 abuse within the medical assistance program. The office's Medicaid fraud
7 hotline shall be the official Medicaid fraud hotline of the state of New
8 York. When a tip is received through the office's Medicaid fraud
9 hotline, the inspector shall follow procedures of the office to deter-
10 mine if such tip is a credible allegation and, if a tip is determined to
11 be a credible allegation, all information contained in such credible
12 allegation shall be shared with the Medicaid fraud control unit of the
13 office of the attorney general and with any prosecutor of competent
14 jurisdiction;
15 5. to keep the governor, attorney general, state comptroller, tempo-
16 rary president and minority leader of the senate, the speaker and the
17 minority leader of the assembly, and the heads of agencies with respon-
18 sibility for the administration of the medical assistance program
19 apprised of efforts to prevent, detect, investigate, and prosecute fraud
20 and abuse within the medical assistance program, and to provide a quar-
21 terly briefing to the legislature on activities of the office. At the
22 end of each calendar year, the inspector shall compile a report contain-
23 ing information on all tips that were received through the office's
24 Medicaid fraud hotline. The purpose of such report shall be to determine
25 how many tips were received through such hotline, how many tips received
26 through such hotline were investigated, who conducted the investigation
27 on each tip that was investigated, and the outcomes of any such investi-
EXPLANATION--Matter in italics (underscored) is new; matter in brackets
[] is old law to be omitted.
LBD16283-01-6
A. 11731 2
1 gations. Such report shall be provided to the governor, the temporary
2 president of the senate, the speaker of the assembly, the minority lead-
3 er of the senate, the minority leader of the assembly and the attorney
4 general;
5 7. to make information and evidence relating to suspected criminal
6 acts which [he or she] such inspector may obtain in carrying out [his or
7 her] such inspector's duties available to appropriate law enforcement
8 officials and to consult with the deputy attorney general for Medicaid
9 fraud control, the welfare inspector general, and other state and feder-
10 al law enforcement officials for coordination of criminal investigations
11 and prosecutions.
12 The inspector shall refer suspected fraud or criminality to the deputy
13 attorney general for Medicaid fraud control and make any other referrals
14 to such deputy attorney general as required or contemplated by federal
15 law. At any time after such referral, with ten days written notice to
16 the deputy attorney general for Medicaid fraud control or such shorter
17 time as such deputy attorney general consents to, the inspector may
18 additionally provide relevant information about suspected fraud or
19 criminality to any other federal or state law enforcement agency that
20 the inspector deems appropriate under the circumstances.
21 Notwithstanding any other provision of this subdivision to the contra-
22 ry, if the inspector determines through procedures of the office that a
23 tip received through the office's Medicaid fraud hotline is a credible
24 allegation, all information contained in such credible allegation shall
25 be shared with the Medicaid fraud control unit of the office of the
26 attorney general and with any prosecutor of competent jurisdiction.
27 Within thirty days of such information being shared with the Medicaid
28 fraud control unit of the office of the attorney general and any prose-
29 cutor of competent jurisdiction, there shall be a determination as to
30 whether such credible allegation will be investigated and, if so, which
31 jurisdiction will lead such investigation. Such determination shall be
32 shared with the inspector. Upon the completion of such investigation
33 into such credible allegation, the inspector shall be notified of the
34 outcome of such investigation;
35 § 2. This act shall take effect immediately.
