Bill Text: NY S02554 | 2013-2014 | General Assembly | Introduced

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Bill Title: Relates to enforcement actions by the office of the Medicaid inspector general.

Spectrum: Partisan Bill (Republican 1-0)

Status: (Introduced - Dead) 2014-01-08 - REFERRED TO HEALTH [S02554 Detail]

Download: New_York-2013-S02554-Introduced.html

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                           S T A T E   O F   N E W   Y O R K
       ________________________________________________________________________
                                         2554
                              2013-2014 Regular Sessions
                                   I N  S E N A T E
                                   January 22, 2013
                                      ___________
       Introduced  by  Sen.  MARCELLINO  -- read twice and ordered printed, and
         when printed to be committed to the Committee on Health
       AN ACT to amend the  public  health  law,  in  relation  to  enforcement
         actions by the office of the Medicaid inspector general
         THE  PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND ASSEM-
       BLY, DO ENACT AS FOLLOWS:
    1    Section 1. Subdivision 6 of section 32 of the public  health  law,  as
    2  added by chapter 442 of the laws of 2006, is amended to read as follows:
    3    6.  to pursue civil and administrative enforcement actions against any
    4  individual or entity that engages in fraud, abuse, or illegal or improp-
    5  er acts or unacceptable practices perpetrated within the medical assist-
    6  ance program, including but not limited to: (a) referral of  information
    7  and  evidence to regulatory agencies and licensure boards; (b) withhold-
    8  ing payment of medical assistance funds in  accordance  with  state  and
    9  federal laws and regulations; (c) imposition of administrative sanctions
   10  and penalties in accordance with state and federal laws and regulations;
   11  (d)  exclusion  of providers, vendors and contractors from participation
   12  in the program; (e) initiating and maintaining actions for civil  recov-
   13  ery  and,  where  authorized by law, seizure of property or other assets
   14  connected with improper payments; and entering into  civil  settlements;
   15  and (f) recovery of improperly expended medical assistance program funds
   16  from  those  who  engage  in fraud or abuse, or illegal or improper acts
   17  perpetrated within the medical assistance program.  THE INSPECTOR  SHALL
   18  NOT  APPLY  ANY  EXTRAPOLATION  METHOD  TO A CATEGORY OF ERROR OR DEFECT
   19  WITHIN A SAMPLE UNLESS THE INSPECTOR  SHALL  FIRST  DETERMINE  THAT  THE
   20  CATEGORY  OF ERROR OR DEFECT IN THE BILLING OR OTHER PRACTICE IDENTIFIED
   21  BY THE INSPECTOR IN THE SAMPLE OF CLAIMS EXCEEDS A RATE OF FIVE  PERCENT
   22  WITHIN  THE  SAMPLE OF CLAIMS. In the pursuit of such civil and adminis-
   23  trative enforcement actions under this subdivision, the inspector  shall
   24  consider  the  quality and availability of medical care and services and
   25  the best interest of both the medical assistance program and recipients;
   26    S 2. This act shall take effect on the first of January next  succeed-
   27  ing  the  date  upon which it shall have become a law and shall apply to
   28  enforcement actions commenced on or after such date.
        EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                             [ ] is old law to be omitted.
                                                                  LBD07234-01-3