House Panel Wants NY Medicaid Documents

11:11 PM, Apr 22, 2013   |    comments
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By Brian Tumulty

Gannett Washington Bureau

WASHINGTON - A continuing investigation into New York's apparent misuse of federal Medicaid money has prompted a new request for documents from the inspector general for the state's Medicaid program.

The House Oversight and Government Reform Committee last week asked the state agency to document how many undercover investigators it has employed since 2009 and for information about its relationship with several health care providers.

The first request for the number of undercover agents was prompted by a recent story in the Albany Times-Union outlining missteps by the state agency in hiring an outside firm to handle undercover investigations. Delays related to the public bidding process have cost the state tens of millions it otherwise would have recovered by tracking down fraud and abuse, the story said.

The congressional committee also wants documents related to the state's development of new audit protocols that may have delayed some investigations.

And the congressional panel wants communications between the state and several vendors, including Visiting Nurse Service of New York, Logical Wave Technologies, Marra Pharmacy, and Town Total Health of New York City.

The state has acknowledged receiving the request.

The seriousness of the issue was underscored earlier this month when New York began its new fiscal year with $1.1 billion less in federal Medicaid money as a consequence of the apparent mismanagement.

The state says it was able to protect its Medicaid services by delaying certain investments, cutting $90 million from the Office for People with Developmental Disabilities and taking other steps.

The reduction in federal funding was prompted by findings by federal auditors and the congressional oversight panel that New York has over-billed the federal government for Medicaid services for years. The House committee estimated New York over-billed by $1.27 billion in 2011 for 1,313 developmentally disabled patients living at large state-run facilities. That investigation was precipitated by a series of stories by the Poughkeepsie Journal.

Media outlets around the state, including the New York Times, have reported numerous other cases of over-billing and outright fraud.

In February the House committee released another report saying 12 executives at nonprofits funded by the New York Medicaid program each received more than $500,000 in annual compensation in 2011. The information was gathered from Form 990 tax information nonprofits are required to file with the Internal Revenue Service.

The February report said more than 100 executives at Medicaid-funded nonprofits had received more than $200,000 a year, which it called "excessive.''

Earlier this month, the inspector general for the U.S. Department of Health and Human Services recommended the state refund $7.3 million for issuing duplicate identification numbers to Medicaid beneficiaries, which allowed double-billing.


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