New York has recovered more than double the federal requirements for improperly paid Medicaid funds, according to New York Medicaid Inspector General James G. Sheehan.
Under the Federal-State Health Reform Partnership - a federal program that sets requirements for Medicaid fraud and abuse recoveries - the federal government set and New York agreed to a recovery target of $215 million for federal fiscal year 2008.
Sheehan said the state recovered $551 million. This number combines reported collections identified through the fraud and abuse efforts of a number of New York state agencies.
"To understand the significance of this success, consider this: The total that all 50 states recovered in 2007 was $305 million," said Sheehan. "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'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 U.S. 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.
"New York state is leading the way in monitoring and identifying Medicaid fraud, waste and abuse," said New York Gov. David 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."
The New York 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 and installment payments and through the withholding of future Medicaid payments to the provider.
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.
The agency receives federal funding for some of its efforts under the Federal-State Health Reform Partnership 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.