HAUPPAUGE — New York State Assemblyman Joe DeStefano is backing a new legislative push aimed at tightening Medicaid fraud enforcement, increasing local prosecutorial involvement and creating financial rewards for credible tips that lead to successful cases.
DeStefano joined Suffolk County Executive Ed Romaine, Suffolk County District Attorney Ray Tierney, state Sen. Dean Murray, Sen. Anthony Palumbo and Sen. Mario Mattera in Hauppauge to support a two-bill package targeting fraud within New York’s Medicaid system.
The first proposal would formally designate the Office of the Medicaid Inspector General, or OMIG, as the statewide clearinghouse for Medicaid fraud tips submitted through the 1-877-87-FRAUD hotline. Credible allegations would then be referred to both the New York Attorney General’s Medicaid Fraud Unit and the appropriate local district attorney.
Under the proposal, authorities would have 30 days after receiving a tip to determine whether an investigation will move forward and which agency will lead it. OMIG would also receive the outcome of completed investigations and issue annual reports showing how many tips were received, referred, investigated and resolved.
A second bill would create a Medicaid Fraud Tip Reward Program funded with 1% of money recovered through Medicaid fraud investigations, seizures and forfeitures. People whose documented information directly leads to a guilty plea or criminal conviction could qualify for a financial reward.
DeStefano: Fraud Takes Money From People Who Need Care
DeStefano framed the issue as both a taxpayer concern and a threat to people who rely on Medicaid.
“Every dollar stolen from that system is a dollar taken away from someone who genuinely needs care.”
He said the program exists to support seniors, people with disabilities, low-income families and children, while arguing that New York does not have enough oversight to deal with waste, fraud and abuse.
The Medford Republican represents New York’s 3rd Assembly District and has previously supported legislation involving Medicaid fraud detection, including a proposal that would reimburse counties for fraud, waste and abuse detection software.
Suffolk Officials Want More Local Enforcement
Tierney argued that local prosecutors need greater access to Medicaid fraud complaints.
Under the proposed legislation, credible tips would no longer remain solely within the state-level enforcement structure. Local district attorneys with jurisdiction would receive the information and could take part in investigating and prosecuting cases.
Tierney said the additional authority could help Suffolk investigators pursue cases that might otherwise fall through the cracks.
Romaine also backed the package, saying stronger Medicaid fraud enforcement could protect money intended for people who depend on the health-care program.
Fraud Fight Tied to Affordability
Supporters are also framing the proposals as an affordability issue.
Palumbo argued that waste and fraud ultimately increase pressure on taxpayers and reduce resources available for legitimate public programs. The lawmakers backing the package say stronger oversight and more aggressive prosecution could help recover taxpayer money while protecting the integrity of Medicaid.
The legislation has not yet become law. It would still need approval from the Legislature and the governor before the proposed referral and reward systems could take effect.
For DeStefano, the argument is straightforward: Medicaid should remain available for the residents who genuinely need it, while those who exploit the system should face greater scrutiny and prosecution.