Wednesday, December 10, 2014

In Obamacare's Wake, New York's Tale of Two Medicaid Programs

In Obamacare's Wake, New York's Tale of Two Medicaid Programs:
"On the one hand, just last month Akim Murray, employee of New York City’s Medicaid Reimbursement Unit, pled guilty in U.S. District Court to a Medicaid fraud scheme in which he issued fake reimbursements to “friends and criminal associates” to the tune of more than $1 million.
In 2010, the Poughkeepsie Journal exposed massive overbilling in the state’s program for the developmentally disabled that charged $5,000 per day, or $2 million per patient, bilking the federal government for some $15 billion over 20 years that went right into the state’s coffers.
Indeed, absent several enterprising Albany-based journalists, the scam might still be going on.
In late July, the feds announced that they were seeking $1.3 billion in overpayments from 2010 (and possibly more for additional years).
In a system as vast and complex as New York’s Medicaid program, detecting waste, fraud, and abuse remains a serious challenge.
In 2013 alone, the state Office of the Medicaid Inspector General recovered close to $900 million in “improperly expended Medicaid funds”—perhaps the mere tip of the iceberg."

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