July 19, 2005

NY gov, officials propose Medicaid fraud crackdown

NEW YORK (Reuters) - New York Gov. George Pataki on Tuesday
unveiled a plan to fight Medicaid fraud, while a U.S.
congressman and a state senator called for an audit of the $93
million spent to prevent Medicaid abuse in New York.

Part of the governor's plan includes establishment of an
independent Medicaid Inspector General.

Earlier this year, the state Senate approved a bill
sponsored by Republican Sen. Dean Skelos calling for the
creation of an independent Medicaid Inspector General. The bill
failed to pass in the Assembly.

New York State's health care program for the poor is
projected to cost about $44.5 billion this year, a growing
percentage of the state's budget.

About $11 billion of that comes from New York City; $11
billion from counties and the rest or about $22 billion from
federal matching funds, said Republican U.S. Congressman John
Sweeney, who called for the federal audit on Tuesday along with

New York's Medicaid program costs more than all other
states, including California and Texas, Sweeney said. Moreover,
those states have had a higher success rate in rooting out
Medicaid fraud with fewer resources, he said.

Studies and reports have indicated that fraud and abuse of
the Medicaid system in New York State could range from 10
percent to 30 percent, Sweeney said.

"With that kind of gross misuse, it really demands a
response so the taxpayers and recipients can know that
everything is being done to bring us back to health," he said.

In addition to his call for an inspector general, Pataki
also appointed former federal prosecutor Paul Schechtman to
recommend a series of long-term reforms to improve and expand
the state's efforts to fight Medicaid fraud.

Darren Dopp, a spokesman for New York Attorney General
Eliot Spitzer, said Medicaid fraud recoveries have increased
700 percent since Spitzer took over as attorney general in

"Any review of our activities of Medicaid fraud would show
significant improvement," he said.