Policy: Entitlements

SUNY resolves Medicaid fraud allegations

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New York,Health Care,Medicare and Medicaid,Entitlements,Law,Legal Newsline
Schneiderman

Schneiderman

BUFFALO, N.Y. (Legal Newsline) – New York Attorney General Eric Schneiderman announced a memorandum of understanding on Friday with the State University of New York (SUNY) to resolve allegations of Medicaid fraud.

Schneiderman’s Medicaid Fraud Control Unit (MFCU) alleged that the Daniel Squire Oral Diagnostic & Treatment Center, which is located on SUNY’s Main Street campus in Buffalo, performed dental services over two separate visits without noting the reason for each visit. Medicaid billing rules require that dental clinics perform a cleaning, dental exam and x-rays during a single reimbursable visit with a patient, unless there is a specific reason noted why the services must be performed over multiple visits.

The dental clinic’s practices allegedly resulted in double reimbursement from Medicaid for dental services performed between Jan. 1, 2005, and Aug. 31, 2009. The clinic also allegedly failed to maintain sufficient documentation to substantiate the services it claimed to have rendered to patients, in violation of Medicaid billing laws.

“If services are billed in violation of the rules for Medicaid reimbursements, New Yorkers are owed and deserve that money,” Schneiderman said. “This settlement demonstrates our commitment to recovering taxpayer dollars misspent through violations of the Medicaid program.”

Under the terms of the settlement, SUNY must pay $115,094 to the state to resolve the allegations.

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