Suozzi: Spitzer Misleading In Medicaid Fraud Announcements

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The New York Sun


ALBANY, N.Y. (AP) – State Attorney General Eliot Spitzer’s announcement that investigations into Medicaid fraud last year recovered a record amount of money by his office is misleading, a political opponent said Wednesday.


Tom Suozzi, who is battling Spitzer for the Democratic nomination for governor, said the vast majority of money recovered last year came from a federal lawsuit led by the Department of Justice, not by Spitzer’s office.


Spitzer spokesman Paul Larrabee said the investigation was led by a prosecutor from the Attorney General’s Medicaid Fraud Control Unit. The Attorney General’s Office is required to report all financial recoveries, including those that were part of nationwide settlements, he said.


“Of course some of it comes from multistate efforts … that is the nature of how we do it,” Spitzer said, when asked about Suozzi’s claims.


The criticism from the Nassau County executive came a day after Spitzer aides announced the office had recovered $274 million in 2005, up from $63 million the previous year.


Suozzi said $171 million of last year’s total came from a federal settlement.


“This is not the first time that the attorney general has released misleading recovery numbers,” Suozzi said in a statement.


Suozzi said Spitzer also inflated numbers in 2004 by including $31 million that was the state’s share of a nationwide settlement with two pharmaceutical companies over drug pricing.


Suozzi said New York state continues to lag behind other states in combating fraud.


Between 1999 and 2003, Suozzi said Spitzer’s office spent $142 million to investigate Medicaid fraud, yet recovered only $149 million.


By comparison, California recovered the same amount, but only spent $37.4 million, according to the federal Department of Health and Human Services.


State to state comparisons are meaningless, however, because some states’ Medicaid fraud units may pursue more fraud investigations that do not yield financial recovery _ like prosecutions against nursing homes, Larrabee said.


New York is one of the most aggressive states in protecting the elderly in nursing homes, he said.


At $44 billion, New York state’s Medicaid program is the largest in the nation, topping even California’s, which covers 55 percent more people than New York does.


A report from The New York Times this summer quoted an expert who estimated fraud and waste consumed between 10 percent and 40 percent of New York’s program, although the U.S. General Accounting Office has stated there is no reliable estimate on the amount of fraud.


The state’s Medicaid system has been blamed for driving up the state budget.


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