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NY Agency Has No Record of Required Referrals of Abuse Cases

by Assoicated Press
October 15, 2016

By MICHAEL VIRTANEN, ASSOCIATED PRESS

New York's oversight agency for the disabled has no record of forwarding abuse or neglect reports to the state Medicaid inspector general, a legally required step that's a key part of cracking down on problem facilities.

Such reports are vital to protecting the more than 120,000 disabled people in state care because the inspector general's office has the power to cut off Medicaid funding to troubled facilities to force them to change their ways.

"The law requires them to report," said Michael Carey, an advocate for the disabled who requested the records of the inspector general and the Justice Center, the agency created by Gov. Andrew Cuomo in 2013 specifically to protect the disabled in state care.

Carey said all 18,000 confirmed cases of abuse and neglect since the Justice Center opened should have been forwarded, and the failure to do so constitutes fraud against the federal government, which pays half of New York's $65 billion annual Medicaid bill.

Carey has requested a criminal investigation by Manhattan U.S. Attorney Preet Bharara. His office declined to comment on whether it is investigating.

In its response to Carey earlier this year, the Justice Center said its document search for the number of forwarded cases "failed to yield any responsive records."

The Office of the Medicaid Inspector General, in its responses to Carey, said its search showed it received "no substantiated reports" of abuse since the Justice Center opened.

Both agencies told The Associated Press that there have been "case-by-case" referrals but they don't track them. Neither agency provided numbers or even estimates of case referrals requested by the AP.

The Medicaid inspector general removes about 1,000 health and service providers from the program every year, mostly individuals, cutting off their funding, according to the office.

The Justice Center reported recently that it had substantiated nearly 2,800 abuse and neglect cases through the first eight months of this year. They include 90 involving serious physical or sexual abuse or other serious misconduct by caregivers.

The law that established the Justice Center says: "For substantiated reports of abuse or neglect in facilities or provider agencies in receipt of medical assistance, such information shall also be forwarded by the Justice Center to the office of Medicaid inspector general when such abuse or neglect may be relevant to an investigation of unacceptable practices."

The inspector general's main focus is financial fraud and misconduct. But it also authorizes immediate removal from the program when it is determined "the health or welfare of a recipient would be imminently endangered by the continued participation of any person in the program."

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