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NCJRS Abstract

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NCJ Number: 77637 Add to Shopping cart Find in a Library
Title: Coordinated Work Plans of State Agencies Involved in Fraud and Abuse Investigations - Report to the Legislature
Corporate Author: New York State
Dept of Social Services
United States of America
Date Published: 1977
Page Count: 52
Sponsoring Agency: National Institute of Justice/
Rockville, MD 20849
New York State
Albany, NY 12243
Sale Source: National Institute of Justice/
NCJRS paper reproduction
Box 6000, Dept F
Rockville, MD 20849
United States of America
Document: PDF
Language: English
Country: United States of America
Annotation: This 1977 report describes the activities of those New York State agencies responsible for investigating fraud and abuse in medicaid and social service programs, along with their efforts to avoid duplication of investigative resources.
Abstract: This report first outlines the powers and responsibilities of the following agencies and offices in relation to fraud and abuse: the departments of social services, health, education, and mental hygiene; special prosecutor for health and social services; office of the welfare inspector general; division for youth; and the office of drug abuse services. Problem areas and current investigative activities of State agencies are described for medicaid vendors, beginning with hospitals where the department of health, the DSS, and the special prosecutor have concluded agreements concerning their investigations and pooled resources in some situations. Nursing homes and ambulatory care providers such as pharmacies and practitioners are also covered. Medicaid activities offer a greater potential for duplication of investigative efforts than nonmedicaid programs. Thus, State agencies limit their activities to client fraud, local personnel fraud, and selected vendors. The review of client and personnel fraud notes that local prosecutors handle most cases. Investigative efforts undertaken by State agencies are detailed for proprietary homes for adults, day care, homemaker/housekeeping services, tenant complaints, and foster care. A table compares cash recovered through agencies' fraud and abuse investigations with their expenditures. The appendixes contain a tabular summary of medicaid program functions by agency, agreements between State agencies concerning their investigative programs and a list of common fraud and abuses in health and social services.
Index Term(s): Fraud; Interagency cooperation; Medicaid/Medicare fraud; New York; Program abuse; Welfare services
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