Legislation
SECTION 31
Establishment of the office of Medicaid inspector general
Public Health (PBH) CHAPTER 45, ARTICLE 1, TITLE 3
§ 31. Establishment of the office of Medicaid inspector general. 1.
There is hereby created within the department the office of Medicaid
inspector general. Pursuant to section three hundred sixty-three-a of
the social services law, the department is the single state agency for
the administration of the medical assistance program in New York state,
provided that the office shall undertake and be responsible for the
department's duties as the single state agency with respect to: (a)
prevention, detection and investigation of fraud and abuse within the
medical assistance program; (b) referral of appropriate cases for
criminal prosecution; and (c) recovery of improperly expended medical
assistance funds. Such responsibility shall include, but not be limited
to, medical assistance program audit functions, pursuant to sections
three hundred sixty-four and three hundred sixty-eight-c of the social
services law, and the function of medical assistance program fraud and
abuse prevention, pursuant to sections one hundred forty-five-a and one
hundred forty-five-b of the social services law (transferred to the New
York state department of health from the former department of social
services pursuant to subdivision (e) of section one hundred twenty-two
of part B of chapter four hundred thirty-six of the laws of nineteen
hundred ninety-seven).
2. The head of the office shall be the Medicaid inspector general who
shall be appointed by the governor by and with the advice and consent of
the senate. The inspector shall serve at the pleasure of the governor.
The inspector shall report directly to the governor. The person
appointed as inspector shall, upon his or her appointment, have not less
than ten years professional experience in one or more of the following
areas of expertise: law, provided the experience involves prosecution or
some consideration of fraud; fraud investigation; and auditing. The
inspector may possess comparable alternate experience in the area of
health care or the area of senior management, in either the public or
private setting, provided that such experience involves some
consideration of fraud.
3. The inspector shall be compensated within the limits of funds
available therefor, provided, however, such salary shall be no less than
the salaries of certain state officers holding the positions indicated
in paragraph (a) of subdivision one of section one hundred sixty-nine of
the executive law.
There is hereby created within the department the office of Medicaid
inspector general. Pursuant to section three hundred sixty-three-a of
the social services law, the department is the single state agency for
the administration of the medical assistance program in New York state,
provided that the office shall undertake and be responsible for the
department's duties as the single state agency with respect to: (a)
prevention, detection and investigation of fraud and abuse within the
medical assistance program; (b) referral of appropriate cases for
criminal prosecution; and (c) recovery of improperly expended medical
assistance funds. Such responsibility shall include, but not be limited
to, medical assistance program audit functions, pursuant to sections
three hundred sixty-four and three hundred sixty-eight-c of the social
services law, and the function of medical assistance program fraud and
abuse prevention, pursuant to sections one hundred forty-five-a and one
hundred forty-five-b of the social services law (transferred to the New
York state department of health from the former department of social
services pursuant to subdivision (e) of section one hundred twenty-two
of part B of chapter four hundred thirty-six of the laws of nineteen
hundred ninety-seven).
2. The head of the office shall be the Medicaid inspector general who
shall be appointed by the governor by and with the advice and consent of
the senate. The inspector shall serve at the pleasure of the governor.
The inspector shall report directly to the governor. The person
appointed as inspector shall, upon his or her appointment, have not less
than ten years professional experience in one or more of the following
areas of expertise: law, provided the experience involves prosecution or
some consideration of fraud; fraud investigation; and auditing. The
inspector may possess comparable alternate experience in the area of
health care or the area of senior management, in either the public or
private setting, provided that such experience involves some
consideration of fraud.
3. The inspector shall be compensated within the limits of funds
available therefor, provided, however, such salary shall be no less than
the salaries of certain state officers holding the positions indicated
in paragraph (a) of subdivision one of section one hundred sixty-nine of
the executive law.