Erie County Executive Mark Poloncarz has long advocated for working to lower the costs associated with Medicaid that are within our control—rooting out provider-level waste, fraud and abuse--and the creation of the Office of the Erie County Medicaid Inspector General is the culmination of years of work dating back to his days as Erie County Comptroller.
- In 2009, as Comptroller, Poloncarz issued a report examining Erie County’s Medicaid Anti-Fraud Processes, which found that despite various mechanisms available, the County was not actively engaging in any efforts to control provider fraud. Poloncarz subsequently called on County Executive Chris Collins to reengage in those efforts, which was ignored;
- In July 2011, as a candidate for Erie County Executive, Poloncarz released a policy paper analyzing the County’s Medicaid program and put forth a plan to reduce the burden on Erie County taxpayers that included the creation of an “Erie County Medicaid Inspector General” to work alongside partners in state government to root out waste, fraud and abuse; and,
- On January 3, 2012, his first day in office as County Executive, Poloncarz issued Executive Order #002—Medicaid Fraud and Abuse Task Force, which required the Commissioner of the Department of Social Services, in conjunction with the County Attorney and Comptroller’s Offices, to recommend the methods and procedures to create a Medicaid Anti-Fraud Task Force.
With a new partnership with the New York State Department of Health (“NYSDoH”) and the Office of the Medicaid Inspector General (“OMIG”), Erie County will is the ‘flagship’ of the State’s revamped Demonstration Project process and is the largest municipality outside of New York City to partner with the State on stamping out provider waste and abuse. As part of their three-party Memorandum of Understanding (“MOU”), the State has agreed to fully fund all costs associated with the startup and administration of the County’s efforts.
Eleven (“11”) other counties and New York City have participated in earlier versions of OMIG’s Demonstration Project and some have experienced success in not only deterring but identifying and recovering illegally obtained Medicaid payments to vendors. Recent successes include Monroe County identifying nearly $12 million in Medicaid claim overpayments made to local providers, with OMIG taking action to successfully recover more than $4 million. Monroe County’s local share of these collections amounted to $515,745. New York City was also recently presented with $278,642, which represented their local share of more than $10 million in Medicaid funds recovered over the past three years.
This new task force is comprised of three people, the Erie County Medicaid Inspector General, a senior investigator and a support staffer, and will utilize the latest data-mining and investigatory tools. This unit will serve to lower and help contain costs through the active investigation and auditing of Medicaid providers and the subsequent recovery of illegally obtained Medicaid funds. Additionally, the public presence of the unit will act as a strong deterrent to future waste, fraud and abuse by providers.