Mayor Bloomberg and Governor Pataki Announce New Effort to Fight Medicaid Fraud

Mayor Michael R. Bloomberg Governor George E. Pataki today announced that New York City is now an active partner with the State of New York in the state's pilot Medicaid Fraud, Waste and Abuse Demonstration Project, designed to empower localities, primarily counties, to join with the State to increase vigilance over the Medicaid program.

"Medicaid is projected to cost the City nearly $5 billion in 2007, and this innovative program allows us to play a key role in rooting out fraud and waste committed by certain unscrupulous Medicaid providers," Mayor Bloomberg said.  "We expect that the City's efforts could eventually generate millions of dollars in fraud recoveries and will contribute to restoring the integrity of the Medicaid program.  I would like to thank Deputy Mayors Edward Skyler and Linda Gibbs for working with the state to secure the City's participation in this Demonstration Project."

The City's Human Resources Administration (HRA) already has extensive experience detecting client-related Medicaid fraud and has combined annual recoveries and cost avoidance attributable to investigations of prescription drug fraud of approximately $2.5 to $3 million.  HRA will move quickly to establish an office of Medicaid Provider Fraud Investigation that will work with New York State Office of the Medicaid Inspector General (OMIG) to review and audit New York City Medicaid providers suspected of fraud, waste and abuse.  The City is eligible to receive up to 25% of any recoveries made as a result of the audits it conducts and at a minimum, will be reimbursed for the costs of running this new program.