Examining the Medicaid IG

Comptroller Thomas DiNapoli plans to start a lengthy audit next month of the embattled Office of Medicaid Inspector General. A team of state auditors has scheduled a broad and comprehensive audit, DiNapoli's aides say. The letter sent to Medicaid IG James Cox calls for an examination of performance results and outcomes at OMIG.

Set to start June 3, the first review by the comptroller of OMIG comes after a highly critical assessment by a congressional panel of the state's $56 billion Medicaid program and of OMIG's questionable work to cut down on abuse and waste. It also comes after reports in the Times Union quoting numerous public officials who have worked at OMIG that the operation has discontinued aggressive auditing or investigating of Medicaid fraud and abuse.

Auditors might be able to clarify OMIG's claim to have worked with hospitals and other providers to educate them on proper practices in ways that prevented more than $2.54 billion in improper payments since Gov. Andrew Cuomo replaced former director James Sheehan with Cox. Sheehan had a reputation of cracking down on fraudulent and wasteful operators.

Mark E. Johnson, a spokesman for DiNapoli, said the audit was triggered by indications that OMIG's policing of Medicaid programs deserves scrutiny, based on various reports."New York's Medicaid program is the largest in the country, and the widespread abuse found by various agencies over the years has been well-documented," he said. OMIG "is the principal overseer of the program, conducting thousands of investigations a year and finding hundreds of millions of dollars in abuse. Given the enormity of the program, and recent cutbacks ordered by the federal government, the comptroller believes a thorough look at OMIG and its practices is warranted."

Read more at http://www.timesunion.com/local/article/Examining-the-Medicaid-IG-4550364.php