N.Y. Public Health Law § 31: Establishment of the office of Medicaid inspector general

§ 31. Establishment of the office of Medicaid inspector general. 1.

There is hereby created within the department the office of Medicaid

inspector general. Pursuant to section three hundred sixty-three-a of

the social services law, the department is the single state agency for

the administration of the medical assistance program in New York state,

provided that the office shall undertake and be responsible for the

department's duties as the single state agency with respect to: (a)

prevention, detection and investigation of fraud and abuse within the

medical assistance program; (b) referral of appropriate cases for

criminal prosecution; and (c) recovery of improperly expended medical

assistance funds. Such responsibility shall include, but not be limited

to, medical assistance program audit functions, pursuant to sections

three hundred sixty-four and three hundred sixty-eight-c of the social

services law, and the function of medical assistance program fraud and

abuse prevention, pursuant to sections one hundred forty-five-a and one

hundred forty-five-b of the social services law (transferred to the New

York state department of health from the former department of social

services pursuant to subdivision (e) of section one hundred twenty-two

of part B of chapter four hundred thirty-six of the laws of nineteen

hundred ninety-seven).

2. The head of the office shall be the Medicaid inspector general who

shall be appointed by the governor by and with the advice and consent of

the senate. The inspector shall serve at the pleasure of the governor.

The inspector shall report directly to the governor. The person

appointed as inspector shall, upon his or her appointment, have not less

than ten years professional experience in one or more of the following

areas of expertise: law, provided the experience involves prosecution or

some consideration of fraud; fraud investigation; and auditing. The

inspector may possess comparable alternate experience in the area of

health care or the area of senior management, in either the public or

private setting, provided that such experience involves some

consideration of fraud.

3. The inspector shall be compensated within the limits of funds

available therefor, provided, however, such salary shall be no less than

the salaries of certain state officers holding the positions indicated

in paragraph (a) of subdivision one of section one hundred sixty-nine of

the executive law.