Agency has no record of re­quired re­fer­rals of abuse cases

Daily Freeman (Kingston, NY) - - STATE NEWS - By Michael Vir­ta­nen

AL­BANY >> 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-by­case” 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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