Bill Text: NY A07271 | 2009-2010 | General Assembly | Introduced

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Bill Title: Establishes a rewards program for individuals who provide relevant information to the office of the Medicaid inspector general that leads to the detection and conviction of persons engaging in Medicaid fraud; provides for award of up to 10% of amounts recovered, based on relevancy and accuracy of information.

Spectrum: Partisan Bill (Republican 2-0)

Status: (Introduced - Dead) 2010-01-06 - referred to health [A07271 Detail]

Download: New_York-2009-A07271-Introduced.html

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                           S T A T E   O F   N E W   Y O R K
       ________________________________________________________________________
                                         7271
                              2009-2010 Regular Sessions
                                 I N  A S S E M B L Y
                                    March 27, 2009
                                      ___________
       Introduced by M. of A. BOYLE -- Multi-Sponsored by -- M. of A. ALFANO --
         read once and referred to the Committee on Health
       AN  ACT  to  amend  the public health law, in relation to establishing a
         rewards program for individuals who provide  relevant  information  to
         the  office  of  the  Medicaid  inspector  general  that  leads to the
         detection and conviction of persons engaging in Medicaid fraud; and to
         amend the  social  services  law,  in  relation  to  making  technical
         corrections thereto
         THE  PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND ASSEM-
       BLY, DO ENACT AS FOLLOWS:
    1    Section 1. The public health law is amended by adding a new section 37
    2  to read as follows:
    3    S 37. MEDICAID FRAUD; REWARDS FOR INFORMATION. 1. THE  OFFICE  OF  THE
    4  MEDICAID  INSPECTOR  GENERAL  SHALL PAY A REWARD OF UP TO TEN PERCENT OF
    5  AMOUNTS COLLECTED, OTHER THAN INTEREST, TO ANY INDIVIDUAL  WHO  PROVIDES
    6  INFORMATION THAT LEADS TO THE DETECTION AND CONVICTION OF PERSONS ENGAG-
    7  ING  IN  FRAUDULENT  MEDICAID  PRACTICES,  AS DESCRIBED BY SECTION THREE
    8  HUNDRED SIXTY-SIX-B OF THE SOCIAL SERVICES LAW.
    9    2. THE FOLLOWING INDIVIDUALS MAY NOT  FILE  A  CLAIM  FOR  THE  REWARD
   10  ESTABLISHED PURSUANT TO SUBDIVISION ONE OF THIS SECTION:
   11    (A)  PRESENT  AND FORMER EMPLOYEES WHO RECEIVED THE INFORMATION IN THE
   12  COURSE OF THEIR OFFICIAL DUTIES; OR
   13    (B) THOSE WHO PARTICIPATED IN THE SCHEME TO DEFRAUD THE STATE OF MEDI-
   14  CAID FUNDS.
   15    AN EXECUTOR, ADMINISTRATOR, OR OTHER LEGAL REPRESENTATIVE MAY  FILE  A
   16  CLAIM FOR REWARD ON BEHALF OF A DECEDENT IF THE DECEDENT WAS ELIGIBLE TO
   17  FILE  SUCH CLAIM BEFORE HIS OR HER DEATH. THE REPRESENTATIVE MUST ATTACH
   18  TO THE CLAIM EVIDENCE OF THEIR AUTHORITY TO FILE.
   19    3. AMOUNTS OF REWARDS SHALL BE DETERMINED BY  THE  MEDICAID  INSPECTOR
   20  GENERAL.  INFORMATION  WILL BE EVALUATED IN RELATION TO THE FACTS DEVEL-
   21  OPED BY THE RESULTING INVESTIGATION. REWARDS WILL BE PAID IN  PROPORTION
        EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                             [ ] is old law to be omitted.
                                                                  LBD09337-01-9
       A. 7271                             2
    1  TO  THE  VALUE  OF INFORMATION VOLUNTARILY FURNISHED WITH RESPECT TO THE
    2  AMOUNT OF FUNDS RECOVERED.
    3    S 2. Section 366-b of the social services law, as added by chapter 306
    4  of the laws of 1970, is amended to read as follows:
    5    S 366-b.  Penalties for fraudulent practices. 1.  Any person who know-
    6  ingly  makes  a  false statement or representation, or who by deliberate
    7  concealment of any material fact, or by impersonation or  other  fraudu-
    8  lent  device,  obtains or attempts to obtain or aids or abets any person
    9  to obtain medical assistance to which he OR SHE is not  entitled,  shall
   10  be  guilty  of  a  class  A  misdemeanor,  unless such act constitutes a
   11  violation of a provision of the penal law of the state of New  York,  in
   12  which  case he OR SHE shall be punished in accordance with the penalties
   13  fixed by such law.
   14    2.  Any person who, with intent to defraud, presents for allowance  or
   15  payment  any  false  or  fraudulent  claim  for  furnishing  services or
   16  merchandise, or knowingly submits false information for the  purpose  of
   17  obtaining  greater  compensation than that to which he OR SHE is legally
   18  entitled for furnishing services or merchandise,  or  knowingly  submits
   19  false  information  for  the  purpose  of  obtaining  authorization  for
   20  furnishing services or merchandise under this title, shall be guilty  of
   21  a  class  A  misdemeanor,  unless  such act constitutes a violation of a
   22  provision of the penal law of the state of New York, in which case he OR
   23  SHE shall be punished in accordance with the  penalties  fixed  by  such
   24  law.
   25    S  3.  The Medicaid inspector general shall promulgate rules and regu-
   26  lations for the establishment of procedures for the provision of  infor-
   27  mation  on persons engaging in fraudulent Medicaid practices and for the
   28  implementation of the rewards program.
   29    S 4. This act shall take effect immediately;  provided,  however  that
   30  section one of this act shall take effect January 1, 2010.