Nassau Doctor Denied Medicaid Reinstatement

A Nassau County physician, Mark Shaffer, was denied reinstatement into the New York State Medicaid program following an evaluation of his application by the New York State Office of the Medicaid Inspector General. This denial was based on concerns about his past behavior which had included failure to maintain patient records, allowing unqualified staff to administer inoculations, and filing false reports with the aim of inflating insurance reimbursements.

Shaffer has been excluded from participation in the Medicaid program since 2007 and recently applied for reinstatement. The exclusion was based on a consent order he signed with the New York State Board of Professional Medical Conduct in which he “agreed not to contest” charges of negligence on more than one occasion.

As the result of the signed consent order, his medical license was suspended for one year, with active suspension for the first three months and the final nine months stayed. He was then placed on probation for 36 months and required to practice under the supervision of another physician throughout the 36-month period.

After a full review of the facts supplied to the agency with his re-application materials, OMIG issued the denial for reinstatement into Medicaid. OMIG made this determination via authority under the regulations guiding the agency. Following OMIG’s determination, Shaffer will remain on the Exclusion/Termination list. Providers must make a formal application to be considered for removal from this list. Shaffer must wait at least two years from the date of the denial letter before submitting another application for reinstatement to the Medicaid program.

Details of the process are available on the OMIG Web site, including the ability to check the Exclusion/Termination list for additional names.