Practice Management Alert

On Sept. 3, New York State Attorney General Andrew Cuomo announced a $35 million settlement with Healthfirst, the largest Medicaid managed care provider in New York State. Earlier this year James Boothe, a former senior executive of Healthfirst, was indicted, Cuomo also announced.

The New York Attorney General's Medicaid Fraud Control Unit investigated Healthfirst's practice from 1999 through 2003. During that time period, Healthfirst allegedly compensated its marketing representatives based on productivity, which is a violation of its contracts with state and local government agencies. Healthfirst also made false statements to those agencies about its marketing practices, according to a news release from the New York Attorney General's office.

"This settlement and the corresponding indictment are a clear indication that my office will not tolerate any improper conduct by Medicaid providers, and we will fully prosecute any individuals who violate the law," said Attorney General Cuomo. "Medicaid providers engaged in prohibited compensation practices are committing an act of fraud against New York's taxpayers, and Healthfirst's new management is rightfully taking responsibility and correcting the mistakes of the past. Marketing reps must not engage in a numbers game that could result in ineligible persons being enrolled in the Medicaid program and cost taxpayers more money."

For more information: To read more about the settlement, visit http://www.oag.state.ny.us/media_center/2008/sep/sep3a_08.html.