Health Alert: New York State Legislature Passes Sweeping Health Care Fraud Reform Legislation
9/18/2006
The New York State Legislature recently enacted tough new health care fraud provisions intended to strengthen the state's Medicaid enforcement efforts. Senate Bill No. S8450, which the governor is expected to sign, mandates a reorganization of the state's anti-health-care-fraud system by creating an independent Medicaid inspector general's office that will oversee all Medicaid fraud detection, prevention, and recovery efforts. In addition, S8450 contains provisions directly affecting health care providers, including a requirement that virtually all Medicaid providers must implement a health care compliance program in accordance with the state's requirements. Finally, S8450 creates new criminal offenses for health care fraud against public as well as private health care plans. Health care providers should take note of this legislation because it not only will result in increased Medicaid fraud enforcement efforts but also will impose a new mandate regarding health care compliance programs that goes well beyond federal law.
Although the provisions included in this Mintz Levin Health Alert are the most significant, they capture only a portion of the new fraud legislation. Providers should take immediate steps to prepare for implementation of S8450 by evaluating current compliance program policies, procedures, and processes.
