December 12, 2008
GOVERNOR PATERSON ANNOUNCES $551 MILLION IN MEDICAID RECOVERIES FOR NEW YORK STATE
Office of the Medicaid Inspector General More Than Doubles Federal Medicaid
Fund Recovery Targets Bringing Financial Boost to the State
Governor David A. Paterson today joined New York State’s Medicaid Inspector General (MIG) James G. Sheehan in announcing that New York State has recovered more than double the requirements for recovery of improperly paid Medicaid funds. Under the Federal-State Health Reform Partnership (F-SHRP) – a federal program that sets requirements for Medicaid fraud and abuse recoveries – the federal government set and New York agreed to an ambitious recovery target of $215 million for federal fiscal year 2008. New York State recovered $551 million – more than doubling the Medicaid fund recovery targets set by F-SHRP. This number combines reported collections identified through the fraud and abuse efforts of a number of New York State agencies.
“Today’s announcement demonstrates that New York State is leading the way in monitoring and identifying Medicaid fraud, waste and abuse – all while maintaining the integrity of the program for those who truly need services,“ said Governor Paterson. “As the economic outlook of both the State and nation remain in peril, achieving milestones in areas such as Medicaid recoveries takes a significant first step forward in putting New York back on the right track to economic recovery.“
Medicaid Inspector General Sheehan said: “To understand the significance of this success, consider this: the total that all 50 states recovered in 2007 was $305 million. New York is leading the way in fighting not only against Medicaid fraud but waste and abuse of the system as well. This is crucial in ensuring that those in need have access to appropriate medical services, and, in these difficult financial times, in maintaining the state’s fiscal controls for the Medicaid program.“
New York State’s Medicaid fraud, waste and abuse recoveries have increased significantly over the last two years while federal recoveries are dropping. The latest figures from the United States Department of Justice indicate that the Bush Administration recouped $1.1 billion in federal fiscal year 2008, compared with $1.5 billion in 2007 and $2.2 billion in 2006.
OMIG identifies Medicaid overpayments and subsequent recoveries through audits, investigations and program reviews of Medicaid providers. The State receives recovery payments in various forms including lump-sum payments, installment payments and through the withholding of future Medicaid payments to the provider.
OMIG works in partnership with the Department of Health, the New York State Office of the Attorney General Medicaid Fraud Control Unit, the Office of Temporary Disability Assistance, the Office of Mental Health, the Office of Alcoholism and Substance Abuse Services, and the Office of Mental Retardation and Developmental Disabilities. Additionally, the Island Peer Review Organization – New York’s fiscal intermediary for the Medicaid program – participates in F-SHRP recoveries as well. On a federal level, OMIG collaborates with officials from the Centers for Medicare and Medicaid Services and the Office of the Inspector General within the Department of Health and Human Services.
OMIG was officially established as an independent office within the New York State Department of Health in the fall of 2006. The agency receives federal funding for some of its efforts under the F-SHRP program, which required the State to meet a series of conditions, one of which was to meet specific fraud, waste and abuse recoveries over a five-year period.
