OMIG works to enhance the integrity of the New York State Medicaid program by preventing and detecting fraudulent, abusive and wasteful practices within the Medicaid program and recovering improperly expended Medicaid funds while promoting high quality patient care.

OMIG WORKS TO KEEP BRONX DENTIST CONVICTED OF WELFARE FRAUD OUT OF THE MEDICAID PROGRAM

Albany, N.Y. (March 6, 2012) – The Office of the Medicaid Inspector General (OMIG) works to prevent Medicaid fraud, waste and abuse by keeping dishonest providers out of the Medicaid program.

In 2010, the New York County District Attorney's Office charged a Bronx dentist with committing a fraudulent welfare act, grand larceny and offering a false written statement. Following her indictment on these charges, the OMIG excluded the Bronx dentist from the Medicaid program on March 3, 2010, finding that her exclusion was in the best interest of the Medicaid program. The dentist was ultimately convicted on these charges.

Over a year after OMIG's exclusion, the dentist applied to New York State for re-enrollment in the Medicaid program as a Medicaid provider. Based on the dentist's history of fraudulent behavior and her previous exclusion, the OMIG denied the application, finding that her conviction had a direct bearing on her ability to be fiscally responsible to the Medicaid program.

The dentist's conviction was based on misrepresentation of her income on applications for public assistance benefits. In order to qualify for these benefits, the dentist claimed that she was unemployed. In actuality, while practicing as a Medicaid provider, this dentist earned approximately $100,000 annually. From 2007 to 2009, the dentist collected public assistance benefits by maintaining that she was unemployed. The dentist was sentenced to five years probation, fined $5,000 and was ordered to pay restitution in the amount of nearly $8,000.

The OMIG performs secondary reviews of all enrollment applications that involve sanctioned individuals. By conducting these intensive front end reviews, the OMIG works to ensure that bad Medicaid providers remain out of the Medicaid program.

You can help OMIG identify fraud, waste, and abuse in the Medicaid system. If you suspect Medicaid fraud, waste or abuse, please call our toll-free hotline at 1-877-87 FRAUD (1-877-873-7283) to file a complaint.