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NY State goes easy on Medicaid audits in response to industry pressure

New York State had been off to a good start in cracking down on health care fraud. The New York Times reports that efforts under former Gov. George Pataki resulted in $1.5 billion in overpayments being recovered in 4 years and other states rushed to emulate New York.

But pressure from the politically powerful health care industry has resulted in a noticeable easing in enforcement.

In 2011 Gov. Andrew Cuomo dismissed the state’s first Medicaid Inspector General, James Sheehan, a former Assistant United States Attorney well-known for his efforts against health care fraud. Sheehan had been extremely successful, exceeding recovery targets. The Times says that his successor, James Cox, was told to cooperate with providers on changes in auditing methods.

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