New York Has 90 Days To Answer Fraud Mismanagement, CMS Shares

WASHINGTON — As the Trump administration continues to wage its war on fraud, the Centers for Medicare and Medicaid Services (CMS) says it has taken steps to crack down on the apparent widespread misuse of federal funds in the state of New York.

CMS officials hosted a press briefing on Wednesday to share updates about its ongoing efforts to eliminate fraud, waste and abuse across Medicare and Medicaid programs. There, the agency issued an official warning to the state of New York as an ongoing law enforcement investigation reveals rampant fraudulent healthcare centers in the state.

Dan Brillman, Director of Medicaid and Deputy Administrator at CMS, announced Wednesday the agency issued a compliance warning letter for failure to oversee its Medicare and Medicaid programs. New York has 30 days to answer and 90 days to come into compliance with the agency’s orders, Brillman shared with the gathered press.

“If New York can’t produce a corrective action plan, the question shifts from how to fix it to whether it can be fixed at all and should this even continue,” Brillman said. “The governor needs to take a hard look and make hard decisions not around the margins. This requires bold and serious action.”

Brillman said the state of New York spends more on Medicare and Medicaid programs per resident than any other state — to the tune of $126 billion dollars per year.

“What I say yesterday when we were there infuriates me,” Brillman said.

CMS Deputy Director Kim Brandt said she conducted audits of 15 so-called “Social Adult Daycare Centers (SADCS),” and found pre-filed Medicare and Medicaid billings for listed individuals who were not participants at the center.

One such center also filed claims to request wheelchairs and disability aid.

“There were no wheelchairs there,” Brillman said at the briefing. “And those SADCS they do not provide medical care at all.”