Medicaid Fraud Control Unit Recovers $100,000 In Settlement With Westchester Mental Health Center

The Medicaid Fraud Control Unit (MFCU) of the Office of the Attorney General today announced that the Mental Health Association of Westchester County, Inc. (MHAW), has agreed to repay more than $100,000 to taxpayers for services that the organization failed to properly document as having provided to Medicaid recipients.

"The taxpayer-funded Medicaid program was designed to assist citizens in need," said Thomas F. Staffa, Acting MFCU Co-Director. "This financial recovery will go a long way in ensuring that those needs are being properly met."

The settlement is based on an audit conducted by the MFCU. In reviewing the Medicaid billing records for MHAW, the audit revealed that, between January 1996 and October 1999, the organization received Medicaid reimbursement for outpatient clinic services that either were not supported by entries in recipients’ charts or that were for services different from those documented in the charts. As a result, MHAW has agreed to make restitution of $108,414 to the Medicaid program.

"Once the problem was brought to the attention of the organization, it cooperated fully with the investigation and readily agreed to reimburse the State," said Acting MFCU Co-Director Karen I. Lupuloff.

In 1999, MFCU redirected resources by putting greater emphasis on fulfilling the unit’s statutory mandate of identifying those health care providers who were improperly billing the state’s $28 billion Medicaid program. Over the last three years, this new approach to enforcement has resulted in the recovery of more than $58 million, a 300 percent increase in restitution.

MHAW is a not-for-profit mental health organization that provides diagnostic and treatment services on an outpatient basis in Westchester County. The organization’s main office is located at 2269 Saw Mill River Road in Elmsford.

The audit-investigation was conducted by Special Assistant Attorney General Gilbert Epstein, Supervising Special Auditor Investigator John S. Regan, and Special Investigator Frank Bluszcz, all assigned to the MFCU’s Pearl River Regional Office.