Responding as if on cue to an expose in the New York Times this week on Medicaid fraud in New York, the Pataki administration yesterday reversed its earlier opposition to the creation of an inspector general for the giant entitlement program and authorized a variety of other measures aimed at pinpointing abuse and eliminating waste.

Following a year long investigation of the $44.5 billion health care delivery program for the poor and disabled, the Times found that New York spends nearly twice the national average on its more than 4 million Medicaid recipients and quoted one expert as saying as much as 40% of all claims submitted by doctors and other service providers are “questionable.”

The report prompted a press conference by an upstate Republican congressman, John Sweeney, and a Republican state senator from Long Island, Dean Skelos, who sponsored a bill that passed the Senate earlier this year calling for the creation of an inspector general. The two Republican lawmakers are calling for a federal investigation into Medicaid abuse in New York.

The Times report highlighted a number of egregious abuses by doctors and other vendors that helped illustrate how the giant program has come to consume nearly half of New York’s annual budget even as lawmakers from both parties have resisted measures that would allow for greater scrutiny of its claims or a reduction of its benefits. Mr. Pataki’s announcement yesterday suggests lawmakers may no longer be able to resist reforms.

“If there is $1 that is fraudulent that has not been aggressively pursued, then that’s got to change,” Mr. Pataki said yesterday after an economic development announcement at the campus of the State University of New York at Albany. “I don’t know a number, but it’s clear we have to do more, and we will do more.” Mr. Pataki’s office announced the new inspector general position, a proposal the governor previously resisted, one hour after the Albany event.

The speaker of the state Assembly, Sheldon Silver, was less aggressive in his rhetoric when asked yesterday about the Times report. The Manhattan Democrat instead defended the Medicaid fraud unit headed by New York’s attorney general, Eliot Spitzer, who is running for governor next year. Mr. Silver suggested that more money and better computers would increase collections within the fraud unit, which was criticized in the Times report.

“If you give the resources to the attorney general, you will have even better productivity,” Mr. Silver said. “Previous to this attorney general, we had less than one quarter of what the attorney general has recovered. Double his resources and we will see exponentially higher recoveries.”

Investigators at Mr. Spitzer’s Medicaid fraud unit recovered $65 million last year on a budget of $35 million, the largest annual recovery in the unit’s 29-year history. Still, Republicans in the Senate earlier this year said the unit has been far less efficient in making fraud recoveries than states like New Jersey that have an inspector general in place.

The majority leader of the Senate, Joseph Bruno, a Rensselaer Republican, called a press conference in early April in which he said New York’s Medicaid fraud unit collects 72 cents for every dollar it spent from 2001 to 2003. He said New Jersey collected $5.76 for every dollar it spent on fraud prevention during the same period. Mr. Bruno’s office was quick to release a statement in support of Mr. Pataki’s proposal yesterday.

“The New York Times’s recent series of articles based on a year-long investigation accurately details the depth of the Medicaid fraud problem that costs taxpayers millions of dollars every day …” Mr. Bruno said. “This must change. It is critical that the Assembly act now on the Senate’s proposals to reign in Medicaid fraud hat is out of control and jeopardizing the entire Medicaid system.”

Mr. Pataki named a former federal prosecutor with the U.S. Attorney’s office for the Southern District of New York and a former prosecutor in the Manhattan District Attorney’s office, Paul Shechtman, as the Medicaid inspector general. The appointment was made through an executive order, meaning it does not require legislative approval. Mr. Shechtman teaches at Columbia Law School.