Senate Passes Carlucci Bill to Combat Medicaid Fraud

Albany, NY – (5/24/16) - Senator David Carlucci (D – Rockland/Westchester) announced that the Senate has passed S2198, legislation that will allow the Office of the Medicaid Inspector General to refer suspected fraud or criminality to any prosecutor of competent jurisdiction, including local District Attorneys.

Current law prohibits District Attorneys across New York from receiving referrals on suspected Medicaid fraud or abuse from the Office of Medicaid Inspector General (OMIG), which conducts its own internal investigation. Senator Carlucci’s bill would clarify the law to allow for referrals to be sent from OMIG to a District Attorney for further investigation and possible criminal charges.

New York State spends more on Medicaid than any other state in the country and has some of the highest number of fraud cases. Although experts are unsure of the exact fraud numbers, in 2012 Donald Berwick, a former head of the Centers for Medicare and Medicaid Services (CMS), and Andrew Hackbarth of the RAND Corporation, estimated that fraud (and the extra rules and inspections required to fight it) added as much as $98 billion, or roughly 10%, to annual Medicare and Medicaid spending—and up to $272 billion across the entire health system.

 “It is inexplicable that our local district attorneys are barred from prosecuting Medicaid fraud that takes place within their county as a result of bureaucratic red tape. This legislation will improve communication and cooperation with the State to increase our ability to fight fraud, save taxpayer money and hold offenders accountable for their crimes,” said Senator David Carlucci.

 “Here in Rockland County we have been very aggressive going after Medicaid fraud,” said Rockland District Attorney Thomas Zugibe. “Working together with Senator Carlucci we passed legislation in the Senate to increase cooperation between the State and localities. This will give District Attorneys like myself additional tools to go after fraudulent cases and ultimately save taxpayer dollars.”