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U.S. Assails Albany's Efforts on Medicaid Fraud - New York Times

By Robin Mathias
Created Jun 7 2006 - 11:29am

NY Medicaid has a data warehouse that could be used to fight fraud, so why aren’t they using it effectively? Looks like another case of underfunding [1]. Counties want to investigate fraud themselves using the database, but they are meeting resistance from the state. Here are a few excerpts from the NY Times:

U.S. Assails Albany’s Efforts on Medicaid Fraud - New York Times [2]

A scathing federal report on New York State’s efforts to root out Medicaid fraud criticized the state for inadequate staffing and lack of commitment to tracking down and punishing health care providers who might be abusing the system.

The department has only 17 people working in data mining, according to the report, and both the new Medicaid inspector general and the state comptroller’s office complained to investigators that the department was not doing enough with the database.

In their response to the investigation, state health officials said their goal was to make the prevention program so good that there would be no fraud — an aim the federal regulators dismissed as unrealistic.


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