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Jul 31, 2019

Judge strikes down New Hampshire’s Medicaid work requirements

A federal judge expanded the legal obstacles Monday to the Trump administration’s efforts to compel certain poor people to get jobs in exchange for Medicaid, ruling that New Hampshire cannot move ahead with such new requirements. The ruling marks the third state for which U.S. District Judge James Boasberg has held that federal health officials […]

Jun 5, 2019

State Medicaid bought erectile dysfunction drugs for sex offenders

New York state’s Medicaid program paid more than $60,000 for sexual and erectile dysfunction (ED) drugs and treatments for 47 sex offenders, according to an audit released Wednesday by state Comptroller Thomas P. DiNapoli. In total, Medicaid made more than $930,000 in payments for ED drugs and treatments for recipients, including sex offenders that are […]

Oct 30, 2015

NY enrolled dead in Medicaid

ALBANY — Flaws in New York’s health exchange resulted in 21 dead people being enrolled in Medicaid and 333 getting continuing government-funded health coverage after they died, according to audit results released Thursday. The state comptroller’s office reported that its auditors found overpayments of $3.4 million for the year starting Oct. 1, 2013, when the […]

Jul 22, 2015

Restitution vacated in Medicaid fraud case

A former Oneida County drug treatment center director will not have to pay the state $675,984 it claimed was owed in restitution for improperly billing Medicaid by having clients simultaneously enrolled in two programs. The Appellate Division, Fourth Department has ruled the state only supplied auditing documentation of its conclusion on the amount owed, but […]

Nov 12, 2013

Court of Appeals — Medicaid: Koch v. Sheehan

New York State Court of Appeals Medicaid Physician Suspension — Authorization Koch v. Sheehan No. 153 Judge Read Background: The lower court had annulled the Office of the Medicaid Inspector General’s determination to terminate the petitioner-physician’s participation in the Medicaid program on the basis of a Bureau of Professional Medical Conduct consent order, and directed […]

Oct 25, 2013

Michigan man defrauds NY Medicaid

A Michigan man who illegally billed Medicaid for physician’s services after obtaining enrollment as a Medicaid provider by using a fraudulently obtained New York medical license was sentenced Thursday in Allegany County. Fitzgerald A. Hudson, 53, of Dearborn, Mich., pleaded guilty to fourth-degree grand larceny and was sentenced to one year prison and ordered to […]

Aug 11, 2013

Fourth Department — Medicaid: Donvito v. Shah, et al.

Appellate Division, Fourth Department Medicaid Look-Back Period — Motivation for Medicaid Coverage Donvito v. Shah, et al. TP 12-02248 Transferred from Supreme Court, Onondaga County Background: The petitioner, an administrator of an estate, commenced an Article 78 proceeding challenging the determination that a seventh-month delay on the decedent’s eligibility for Medicaid coverage was proper[...]

Mar 5, 2012

NY: Insurers to cover women’s contraception choice

ALBANY — New York state on Monday warned health insurers they would lose state contracts if women on Medicaid are denied their choice of higher-cost, brand-name contraceptives unless cheaper, generic methods “fail first.” The move comes after The Associated Press reported Monday that some New York Medicaid patients were told they had to switch to […]

Feb 24, 2012

Fourth Department — Medicaid: Godfrey v. Shah

Appellate Division, Fourth Department Medicaid Request for Medical Device Godfrey v. Shah TP 11-01540 Transferred from Supreme Court, Erie County Background: The petitioner commenced an Article 78 proceeding challenging the determination that denied her request seeking approval to purchase a Bantam Stander device with options. The petitioner is a 7-year old Medicaid recipient with multiple [&helli[...]

Feb 22, 2012

Fourth Department — Medicaid: County of Niagara v. Daines

Appellate Division, Fourth Department Medicaid Overburden Expenditures — Reimbursement County of Niagara v. Daines CA 11-01219 Appealed from Supreme Court, Niagara County Background: The petitioner, a county that is also a social services district, commenced an Article 78 proceeding seeking to annul the denial of its claim for reimbursement for Medicaid expenditures known as “overburden [&hell[...]

Jul 28, 2011

Medicaid compliance big issue for New York

Protecting the state from Medicaid fraud, abuse or just plain mistakes is an important aspect of the work of the New York State Office of the Medicaid Inspector General (OMIG) since the state spends more for Medicaid than any other state in the country.

May 4, 2011

State wants Medicaid payment recovery

It’s no secret state and county governments are facing economic hardships and looking at whatever ways they can to save and raise money. But a new, undeveloped — as of yet — state law to expand the definition of estate to include life estates ...

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