New York Makes $851 Million in Medicaid Recoveries

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New York Governor Andrew Cuomo announced the largest single year of recoveries of taxpayer dollars in the history of the Office of the Medicaid Inspector General (OMIG). Preliminary calculations show the administration recovered more than $851 million dollars for 2013. Recoveries come from Medicaid providers who inappropriately billed Medicaid and individuals who received services to which they were not entitled.

This is a 34% increase over the previous three years. OMIG’s recoveries are the highest on record for any state Medicaid program integrity unit. OMIG has worked to eliminate fraud through aggressive responses to allegations of fraud in social adult day care, excluding unscrupulous providers, and focusing on ineligible individuals.

Throughout 2013, OMIG made several notable enforcement actions including busting a fraud ring in Brooklyn. One notable case included an individual who vacationed in Las Vegas and drove a Porsche, Aston-Martin, and a BMW. This work lead to six prosecutions by the Brooklyn District Attorney for welfare fraud, grand larceny, and offering a false instrument for filing.

OMIG recovered $211 million from inappropriate Medicaid billing in New York State’s share for taxpayers during 2013.

“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. Eliminating this kind of waste is vital to transforming New York’s healthcare system, and this year’s tremendous amount of recoveries shows that we are well on our way to building a healthier and fairer New York,” Governor Cuomo said.