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New York Medicaid Recoveries Set Record

Posted in Fraud and Abuse, Home Healthcare, Litigation, Medicare and Medicaid, State Matters, White Collar

On February 3, New York Governor Andrew M. Cuomo (D) announced that the state’s Office of the Medicaid Inspector General (OMIG) recovered more than $851 million in 2013 from investigations and audits of providers. The amount set a record for the state, and was also the highest annual amount ever recovered by any state’s Medicaid program integrity unit.

In his statement, Cuomo said, ““Our focus on cleaning up the Medicaid program is showing record-breaking results, and OMIG’s efforts serve as a role model for other states to follow.” The statement credited new pre-claim reviews, better oversight of pharmacy operations, and improved data sharing and coordination with federal, state, and local partners for the strong results.

Improper billing of Medicaid for home health services for “dual-eligible” consumers that should have been billed to the federal Medicare program accounted for $211 million of the recovery.

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