Mineola, N.Y.- Nassau County Executive Thomas R. Suozzi, joined by Deputy County Executive for Health and Human Services Jack Gallagher and Commissioner of Social Services Bob Sherman, today formally present the County's three-pronged program created to reduce Medicaid fraud and abuse, improve revenue maximization for the County's healthcare infrastructure and locate third party insurance sources. The three prongs consist of three contracts, two that have been passed and one that is waiting a legislative vote, that, together, are estimated to save the county over $6.5 million by next year.

(right to left) County Executive Suozzi; Commissioner Sherman; and Deputy County Executive Gallagher discuss aspects of program with County Contractors.

"This program is a key step forward in our efforts to end the fraud and abuse that has plagued our healthcare programs for too long. Now, we will also be able to increase our revenue and locate third party insurance sources to cover many residents' healthcare," County Executive Suozzi said. "And, most importantly, these contracts will enable us to concentrate our energies and tax dollars on the residents who need it most."

The three-prong program is made up of three separate contracts established to tackle three major problems currently facing the county's healthcare infrastructure:

• Fraud and Abuse contract: This contract will allow Bull Services and SPSS (Statistical Package for Social Services) to install cutting-edge software equipment and analytical tools connected to a massive New York State data warehouse that will enable the County to successfully monitor data for fraud and abuse patterns. This $466,000 contract is expected to save the County almost $5 million by next year.
• Revenue Maximization: This contract will allow Cost Management Services (CMS) to use its high-powered expertise to monitor programs such as Pre-Kindergarten, Early Intervention and Drug & Alcohol for maximum Medicaid reimbursement. Costs for services previously provided by Nassau University Medical Center (NUMC), which may be eligible for Medicaid reimbursement, will also be reviewed. This $200,000 contract is expected to save the County over $1 million by the end of this year.
• Matching Project: This contract will allow Health Management Systems, Inc. (HMS) to monitor all county healthcare claims for third party liability. This will ensure that residents who receive Medicaid do not have any other insurance that they could have used in its place. This contract is based on a contingency fee and will not cost the county anything up front. This contract is expected to save the county between $250,000 and $500,000 by next year.

"These three contracts create a great opportunity to repair the fraud, abuse and neglect our health and human services have suffered for years," Deputy County Executive Gallagher said. "We can now concentrate on moving forward and perfecting the services that we provide to our residents."

"These contracts will permit Nassau County to receive maximum Medicaid reimbursement for services provided and at the same time, send the message that Medicaid fraud will not be tolerated," Commissioner Sherman said.