May 25, 2010
COUNTY INVESTIGATIONS UNIT TAKES MAJOR STEPS
TO UNCOVER HEALTHCARE WASTE, FRAUD & ABUSE
State Funded Program Allows Nassau County to Conduct Audits of Medicaid Providers
Nassau County Executive Edward P. Mangano announced today the County’s success in using state-of-the art data mining tools to combat Medicaid provider fraud, waste and abuse. By using sophisticated technology to identify out-of-the ordinary claims made by Medicaid providers, the Nassau County Medicaid Investigations Unit submitted a list of names to the New York State Office of the Medicaid Inspector General (OMIG) requesting clearance to audit various provider types. While the list of providers remains confidential, the OMIG approved a significant number of the names submitted. In addition to these approved targets, the county has requested clearance to audit an additional 50 providers. The audit process involves examining provider books and records. If errors exist, the county will be able to recoup taxpayer dollars.
Medicaid audits in New York City and other counties throughout the state have resulted in questionable claims totaling millions of dollars and recoveries already coming in. Nassau County officials hope to experience similar results and also expect that the program will serve as a deterrent to providers who abuse the system.
“Nassau County will not tolerate waste, fraud and abuse,” said County Executive Ed Mangano. “We will restore accountability and ensure integrity in the Medicaid program that is largely funded by property taxes. Providers who cheat the system will be located and prosecuted to the fullest extent of the law.”
The Medicaid Investigations Unit, the first of its kind in Nassau County, was created in January 2006 to combat Medicaid provider waste, fraud and abuse. Since its inception, the unit has identified over $4 million in Medicaid provider fraud. Through traditional field investigations and sophisticated data analysis, the unit works closely with police and prosecutors to bring providers who cheat the system to justice.
With the addition of a comprehensive audit component to the program, Nassau County has significantly enhanced its ability to ensure that taxpayer dollars are spent properly and efficiently on medical benefits for those most in need.
Anyone who suspects Medicaid fraud, waste or abuse can contact Nassau County toll free at 1-877-711-TIPS (8477). All caller information is confidential.