House Committee on Oversight and Government Reform Chairman James Comer (R-KY) is seeking information from the Centers for Medicare and Medicaid Services (CMS) concerning reports of Medicaid fraud in New York.
In a letter to CMS Administrator Dr. Mehmet Oz, Comer voiced his concerns that New York, “and likely other states too, are failing to follow federal law by misrepresenting the source of the non-federal share that the State is responsible for providing to trigger federal dollars under the Medicaid [Disproportionate Share Hospital] program.”
“Whistleblowers report that the State has concocted a scheme by which it has forced a safety net hospital to reimburse the State’s portion of the Medicaid match, despite telling the federal government the DSH funds had gone to the hospital,” the letter reads. “Reports on this scheme indicate that the State has engaged in this behavior for more than 20 years, costing taxpayers over $1 billion for one hospital alone, Nassau University Medical Center (NUMC).”
The letter comes as two individuals have pleaded guilty to a $65 million adult day care fraud scheme in Brooklyn, New York. The individuals, Manal Wasef, 46, and Elaine Antao, 46, conspired to “defraud Medicaid by paying health care kickbacks for services that were not provided” at the adult day cares and a home health care company, the Department of Justice explained.
Comer’s letter to Oz follows a July letter sent to New York Governor Kathy Hochul (D), asserting that the state “has been withholding or clawing back Medicaid funds from localities and low-income hospitals in order to buoy its failing balance sheet.”
Similarly, Comer is going after the widespread fraud in Minnesota, calling for Governor Tim Walz (D) and Minnesota Attorney General Keith Ellison will testify on the matter in February.
