FEDS SUSPEND MEDICAID FRAUD FINDING FOR NY WITH MENTION OF JAMES, BELL, AND SARCONE ETAL.--NEXSTAR

 

EXCERPTED---ALBANY, N.Y. (NEXSTAR) — The federal government suspended funding for New York’s Medicaid Fraud Control Unit, accusing the state agency of doing a bad job with criminal enforcement. State officials called the move a political attack—pointing out that the MFCU has recovered hundreds of millions—and called attention to high-profile arrests announced as recently as June 24, June 29, and July 1.To avoid losing everything earmarked for the 2027 fiscal year, HHS Inspector General Thomas March Bell gave the state until July 30 to submit a corrective action plan. New York is supposed to explain exactly how it will better track employee time and rebalance staff to fix what the feds called an inappropriate mix of auditors and investigators. New York would also have to facilitate mandatory monthly cooperation meetings between federal law enforcement and MFCU staff.

HHS denied recertification for New York’s MFCU starting July 1. In his letter, Bell reasoned that they’d filed only nine criminal indictments each in 2023 and 2025, and 18 in 2024. That’s a drop from the hundreds the unit had prosecuted in 2016, 2017, and 2018, according to Sarcone. Bell blamed the lower numbers on a deliberate choice to pursue larger civil fraud lawsuits instead of smaller criminal cases. MORE AT NY's Medicaid Fraud Control Unit accused of poor criminal enforcement