Nassau gets 1st Medicaid fraud restitution

Nassau County has received the state's first reimbursement for Medicaid provider fraud, County Executive Edward Mangano said Wednesday.

Mangano said the payment of $46,524 marks the first time a New York county has shared in restitution resulting from provider fraud.

"These funds are the direct result of arrests and prosecution of fraud . . . by Medicaid home health care aides and pursued for investigation" by the county Department of Social Services, he said.

DSS conducts investigations into the activities of Medicaid providers and refers the findings to the state's Office of the Medicaid Inspector General. Cases are referred to the state attorney general's office for criminal prosecution.

Under a 2006 law, a county can share up to 15 percent of any restitution from these referrals.

DSS Commissioner John Imhof said more than $300,000 was recovered as a result of Nassau's investigations alone, and those funds are split among Nassau County, the state and the federal government," said DSS Commissioner John Imhof.

DSS Director of Investigations Scott Skrynecki said a typical scheme is for a home health care aide to sign in as on-duty, "but not report to work when the aide is supposed to be providing essential medical and special-needs care to Medicaid recipients who cannot care for themselves."

In one case, DSS investigators followed a home health care aide to Jones Beach and observed her surfing for hours while she was being paid to provide care for an adult woman with developmental disabilities.