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GOVERNOR ELIOT SPITZER AND LIEUTENANT GOVERNOR DAVID PATERSON NOMINATE NEW YORK STATE MEDICAID INSPECTOR GENERAL
Governor Eliot Spitzer and Lieutenant Governor David Paterson today announced the nomination of James G. Sheehan to serve as New York State Medicaid Inspector General.
As Medicaid Inspector General, Mr. Sheehan will oversee the fraud and abuse enforcement activities of New York’s $50 billion Medicaid program. The New York State Office of the Medicaid Inspector General audits and investigates Medicaid providers, recovers revenues through its enforcement system, and develops and operates automated health care data detection systems.
“As a career prosecutor specializing in complex health care enforcement and recovery matters, Mr. Sheehan has experience rooting out fraud that dramatically drives up costs and severely threatens the efficiency and delivery of health care services,” said Governor Spitzer. “New York State’s health care spending is the highest in the nation and our system requires dramatic reform. Mr. Sheehan will bring his experience and energy to that effort.”
Mr. Sheehan currently serves as an Associate U.S. Attorney for Civil Programs in the Eastern District of Pennsylvania. He has served as an Assistant U.S. Attorney since 1980, and a supervisory Assistant U.S. Attorney since 1983.
While serving in the U.S. Department of Justice’s Philadelphia office, Mr. Sheehan personally handled over 500 health care fraud matters, as well as managed all civil litigation for the federal Eastern District of Pennsylvania. He has personally led, managed and developed health fraud and kickback cases from pharmacy benefit firms, pharmaceutical manufacturers, medical suppliers, hospitals, nursing homes, and physicians.
From 1999 to 2006, Mr. Sheehan led the government investigation against Medco Health Solutions, which resulted in the recovery of over $155 million, as well as substantial business changes to protect patients and pharmacists. From 1993 to 1997, he was lead counsel in United States v. SmithKline Beecham Clinical Labs, which resulted in a $332 million recovery for the United States.
Mr. Sheehan has supervised joint health care investigation teams that included the FBI, Federal Inspector Generals from many agencies, and private investigators, which resulted in more than $600 million in awards. He has also developed a model Qui Tam Program to identify and pursue fraud cases.
Mr. Sheehan received his B.A. from Swarthmore College and his J.D. from Harvard Law School.
Mr. Sheehan comes to New York State through the Intergovernmental Personnel Act program. This program provides the opportunity for career federal, state and local employees to work at another level of government. The program maintains salary and benefits for participating staff, with any difference paid through the originating agency.
As Medicaid Inspector General, Mr. Sheehan’s annual salary will be $136,000, with the $9,300 difference between that amount and Mr. Sheehan's current salary to be paid by the U.S. Department of Justice.