July 20, 2009

U.S. Department of Justice Settlement Agreement With New York State About Medicaid School Supportive Health Services

The State of New York settled with the U.S. Department of Justice (DOJ) regarding improper Medicaid billing for school supportive health services (SSHS) provided between 1990 and 2001. The federal government investigated whistleblower allegations that New York State, a number of localities with in the state, and certain named individuals violated federal program requirements for SSHS speech therapy services. After investigating, the federal government determined that between June 1, 1993, and June 30, 1996, the state submitted claims for SSHS services that were not provided in accordance with program requirements. The state will repay about $540 million. In addition, the state will not resubmit any of the disputed claims. The state's future SSHS claims will be reviewed annually by an independent review organization.