Medicaid Payments Under Scrutiny In New York City, On Maryland's Eastern Shore

New York City is defending its authorization of in-home care for thousands of patients. Meanwhile, in Maryland, investigators disclosed that they had uncovered evidence of fraud at a drug treatment and mental health clinic. In the background, Wisconsin legislators greenlight plans for a sweeping audit of the state's health program for the poor.

The New York Times: As New York City Defends Medicaid Approvals, Fear Of Suit's Fallout Grows
Medicaid fraud conjures up images of shady doctors, pharmacists and businessmen being led away in handcuffs by federal agents as photographers snap away and television cameras roll. But this week, Medicaid fraud investigators struck out in a new direction as federal prosecutors brought a civil fraud lawsuit accusing the New York City government of using the bureaucracy to run its own Medicaid mill (Hartocollis, 1/12).

The Baltimore Sun: State Withholds Eastern Shore Clinic's Medicaid Payments
State health investigators disclosed Wednesday that they have uncovered evidence of "fraud or willful misrepresentation" by an Eastern Shore drug treatment and mental health clinic, including overbilling and charging for the work of physicians who were not at the facility. The inspector general of the state health department sent a letter Wednesday to Warwick Manor Behavioral Health Inc., near Cambridge, saying the state has suspended all Medicaid payments to the clinic. Warwick Manor treats roughly 2,000 patients a year and billed the state's Medicaid program $1.5 million last year (Calvert, 1/12).

Milwaukee Journal Sentinel: Panel Approves Medicaid Programs Audit
Lawmakers Wednesday approved a sweeping audit of health programs for the poor — one of the largest expenses for state taxpayers. For the past two years, Republicans have sought an audit into Medicaid health programs such as BadgerCare Plus but were blocked by some Democratic legislators and former Gov. Jim Doyle's administration, who argued there was no need for a broad and time-consuming review. Now that Republicans control the Legislature following November's election, they were able to order the audit and won the support of Democrats for it (Stein, 1/12).

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