New York would require sharing credible Medicaid fraud hotline tips

The Medicaid inspector general would review hotline tips and share all information in credible reports with the attorney general's Medicaid fraud control unit and prosecutors with authority over the case. The inspector general's hotline would serve as New York's official Medicaid fraud hotline. The inspector would use the office's procedures to decide whether a tip is credible before the sharing requirement applies. The requirements would take effect immediately if the bill becomes law.

A decision would be required on whether to investigate a shared credible tip and, if so, which authorities would lead. These rules would cover credible hotline tips shared with the attorney general's Medicaid fraud control unit and prosecutors with authority over the case. A credible tip would not automatically require an investigation. The 30-day period would start when the information is shared with the fraud control unit and prosecutors. The inspector would receive the outcome when an investigation ends.

The Medicaid inspector general would compile an annual hotline report for the governor, attorney general, and legislative leaders. The report would cover all hotline tips, count those received and investigated, identify who investigated each tip, and give the investigation outcomes. The inspector would compile the report at the end of each calendar year.