It's Your Money NYC: Hold Your Government Accountable

Funding for '09

$55,661,000

Employees

1,350

Who funds this program?

City

29,360,000 (53%)

State

12,450,000 (22%)

Federal

13,851,000 (25%)

How is the money spent?

Salaries

54,559,000 (98%)

Contractual Services

1,000,000 (2%)

What your money funds:

This program funds the Investigation, Revenue and Enforcement Administration, which is responsible for investigations of alleged fraudulent acts against the social service programs administered by HRA/DSS. The division is comprised of three major operating units: the Office of Investigation [http://www.nyc.gov/html/hra/html/programs/office_of_investigations.shtml], the Office of Revenue and Administration [http://www.nyc.gov/html/hra/html/programs/office_of_revenue_and_administration.shtml], and the Office of Medicaid Provider Fraud and Abuse Investigation (OMPFAI). [http://www.nyc.gov/html/hra/html/programs/fraud_abuse_investigation.shtml]

1. In December 2006, New York City entered into a Memorandum of Understanding with the New York State Office of the Medicaid Inspector General and the New York State Department of Health, authorizing New York City to implement a Medicaid provider fraud and abuse project to target Medicaid fraud, waste and abuse by healthcare and other service providers. As part of its functions, OMPFIA conducts audits of Medicaid providers in New York City suspected of fraud, waste or abuse. In FY08, OMPFAI recovered $80.7 million in Medicaid and cost avoidance for fraud, waste and abuse.
2. The Office of Revenue and Administration is divided as the following
3. The Claims and Collections Division: responsible for identifying and collecting overpaid cash assistance grants from persons no longer receiving assistance. It identifies and collects certain excess resources of Medicaid Community Care and institutional care customers.
4. The Liens and Recovery Division: places liens on and seeks reimbursement from the proceeds from any personal injury lawsuits that recipients may have been awarded.
5. The Real Property and Assets: places liens on real estate owned by cash assistance and Nursing Home medical assistance clients.
6. The Supplemental Needs Trust Unit: responsible for reviewing the annual accountings submitted by trustees on behalf of recipients who remain on assistance while holding assets in a trust.
7. The Division of Financial Review and Processing (DFRP): identifies undisclosed income and resources
8. Assistance Reimbursement Unit (ARU): obtains reimbursement of interim cash assistance paid to Safety Net participants who subsequently receive federal Supplemental Security Income (SSI) payments covering the same time period as the cash assistance.
9. Bureau of Fraud and Investigation (BFI): mandated to conduct criminal investigations of individuals and organized groups allegedly attempting or committing fraudulent acts against the social service programs administered by HRA/DSS. BFI's investigations may result in criminal prosecutions, Administrative Disqualification Hearings, Civil Litigation or other appropriate administrative actions. BFI works closely with local, state and federal law enforcement and [https://a069-webapps12.nyc.gov/bfi/index.cfm]prosecutorial agencies to accomplish its