Section 31. Establishment of the office of Medicaid inspector general  


Latest version.
  • 1.
      There is hereby created within the department  the  office  of  Medicaid
      inspector  general.  Pursuant  to section three hundred sixty-three-a of
      the social services law, the department is the single state  agency  for
      the  administration of the medical assistance program in New York state,
      provided that the office shall undertake  and  be  responsible  for  the
      department's  duties  as  the  single  state agency with respect to: (a)
      prevention, detection and investigation of fraud and  abuse  within  the
      medical  assistance  program;  (b)  referral  of  appropriate  cases for
      criminal prosecution; and (c) recovery of  improperly  expended  medical
      assistance  funds. Such responsibility shall include, but not be limited
      to, medical assistance program audit  functions,  pursuant  to  sections
      three  hundred  sixty-four and three hundred sixty-eight-c of the social
      services law, and the function of medical assistance program  fraud  and
      abuse  prevention, pursuant to sections one hundred forty-five-a and one
      hundred forty-five-b of the social services law (transferred to the  New
      York  state  department  of  health from the former department of social
      services pursuant to subdivision (e) of section one  hundred  twenty-two
      of  part  B  of  chapter four hundred thirty-six of the laws of nineteen
      hundred ninety-seven).
        2. The head of the office shall be the Medicaid inspector general  who
      shall be appointed by the governor by and with the advice and consent of
      the  senate.  The inspector shall serve at the pleasure of the governor.
      The  inspector  shall  report  directly  to  the  governor.  The  person
      appointed as inspector shall, upon his or her appointment, have not less
      than  ten  years professional experience in one or more of the following
      areas of expertise: law, provided the experience involves prosecution or
      some consideration of fraud;  fraud  investigation;  and  auditing.  The
      inspector  may  possess  comparable  alternate experience in the area of
      health care or the area of senior management, in either  the  public  or
      private   setting,   provided   that   such   experience  involves  some
      consideration of fraud.
        3. The inspector shall be  compensated  within  the  limits  of  funds
      available therefor, provided, however, such salary shall be no less than
      the  salaries  of certain state officers holding the positions indicated
      in paragraph (a) of subdivision one of section one hundred sixty-nine of
      the executive law.