The number of suspected Medicaid-fraud cases handled by state investigators — ranging from dirty dentists and druggists to millionaires illegally on the dole — more than doubled last year, according to an explosive new report.
The state Office of Medicaid Inspector General referred 208 cases to Attorney General Andrew Cuomo’s office for potential criminal prosecution of health-care providers — a 136 percent increase from 2008.
Meanwhile, the number of suspected cases of Medicaid-patient fraud referred to local prosecutors also skyrocketed.
For example, the number of suspected forgeries tied to the diversion of prescription drugs jumped from 304 to 683.
Overall, the number of substantiated fraud cases involving Medicaid patients increased 50 percent, the report said. A total of 552 cases were referred to New York City investigators for potential prosecution, the report said.
Medicaid Inspector General James Sheehan attributed the surge in cases to an overhaul of his office the last few years that included an increase in the number of undercover investigative staffers and auditors and the use of a new, more sophisticated, data-mining system that flags suspected problems.
“It’s better detection, and more people on the street means more cases. We have the resources and trained people. We’re finding the cases,” Sheehan said.
“We are also getting a lot more reports [of fraud, waste and abuse] from the public and more disclosure from providers. People know we’re looking,” he said.
But one state lawmaker said investigators were just scratching the surface of Medicaid fraud.
State Sen. Marty Golden (R-Brooklyn) said OMIG’s done a much better job of auditing health-care providers to recoup money from billing mistakes than nabbing fraudsters.
“The inspector general has to put more investigators in the street. We’re spending $1 billion a week on Medicaid. Let’s get real,” said Golden.
Sheehan said the state recouped more than $500 million last year from Medicaid fraud, waste and abuses — thanks largely to prosecution by Cuomo’s office. He said OMIG helped save $1.6 billion overall through audits and cost-prevention measures.
New York spends about $52 billion on Medicaid.