THESE ARE THE MAIN POINTS OF CONCERN:
1. THE FORMAT IS JUST LIKE THE ENTERPRISE ZONE FOR DEVELOPMENT WHERE WE SEE THE BALTIMORE DEVELOPENT CORPORATION AS A QUASI-GOVERNMENTAL AGENCY FILLED WITH CONNECTED PEOPLE DECIDING THE WHERE, WHAT, WHEN, AND HOW OF CITY PLANNING AND THROWING COPIOUS BUSINESS TAX CREDITS AT VERY RICH PEOPLE FOR SIMPLY EXISTING. SO IMAGINE THAT SAME FORMAT IN HEALTH CARE AND YOU HAVE HEALTH ENTERPRISE ZONES.
2. SO THERE WILL BE NO COMMUNITY INPUT....THE ZONES WILL BE PLACED WHERE DEVELOPMENT ENVISIONS THE POOR TO BE, NOT WHERE THEY ARE........AND CORPORATE CHAINS OF NEW HEALTH CARE BUSINESS COMPANIES THAT WILL PROBABLY BE STAFFED WITH IMMIGRANT LABOR WILL ACT AS THE CORE OF THESE HEALTH ENTERPRISE ZONES...NOT THE LOCALS.
3. THE GROUPS THAT WILL WIN THE AMAZINGLY SMALL $4 MILLION GRANT TO IDENTIFY AND DEFINE THESE ZONES WE ALREADY KNOW TO BE THE NGOs......THE PRIVATE NON-PROFITS THAT ARE AGAIN FILLED WITH THE WEALTHY WHO TAKE A SHINE TO THE HEALTH ISSUE, PROBABLY FOR PERSONAL GAIN. WE KNOW THAT BECAUSE THE REQUIREMENT FOR APPLYING HAS ALL THE ELEMENTS OF THESE NON-PROFITS AND NONE OF THE ELEMENTS OF A LOCAL, COMMUNITY ORGANIZATION.
MY FAVORITE COMMENTS STARTING WITH ONE OF MY OWN ARE:
NEW YORK'S GOV. CUOMO JUST FIRED HIS NATIONALLY RESPECTED INSPECTOR GENERAL FOR MEDICAID, KNOWN FOR RIGOROUS ENFORCEMENT AND GREAT RECOVERY AND TOLD HIS REPLACEMENT TO BE SOFT ON MEDICAID FRAUD. THE CAPITOL JUST SLASHED 44% OF THE MEDICAID OVERSIGHT FUNDING ON AN AGENCY HAVING 500 PEOPLE OVERSEEING HUNDREDS OF MILLIONS OF MEDICAID TRANSACTIONS A YEAR...WHICH MEANS THERE IS NO OVERSIGHT. HOME HEALTH CARE AND NURSING HOME CARE ARE THE TWO INDUSTRIES WITH THE MOST FRAUD AND THESE TWO ARE A BIG CHUNK OF THE HEALTH ENTERPRISE ZONES. YET YOUR PRESENTATION ON GUIDELINES FOR GRANT DEVELOPMENT NEVER MENTIONS QUALITY CONTROL AND OVERSIGHT PROCEDURES OR VETTING REQUIREMENTS. IT WAS CLEAR THAT ALL CURRENT BUSINESSES WOULD BE ACCEPTED.
BELOW YOU WILL COME TO THE ARTICLE ABOUT CUOMO'S FIRING OF HIS IG AND IT GIVES YOU FIGURES AS TO HOW MUCH FRAUD HAPPENS IN NEW YORK AND YOU CAN BET THAT IS THE TIP OF THE ICEBURG. MARYLAND WAS FAR LOWER ON THE FRAUD METER OF THE CENTER FOR PUBLIC INTEGRITY SO YOU KNOW THERE IS AN ENORMOUS AMOUNT OF FRAUD IN MEDICAID AND MEDICARE. NEVER THE LESS, THE PRESENTERS WERE NOT HAPPY THAT ISSUE SURFACED WITH ANTHONY BROWN'S STAFF PULLING THE MICROPHONE AWAY AND A QUESTION AS TO 'WHAT DOES THAT HAVE TO DO WITH THIS DISCUSSION'?
THE ANSWER OF COURSE IS EVERYTHING!!!!!!!
I WAS TOLD THERE WOULD BE NO FRAUD IN THESE HEALTH ENTERPRISE ZONES. I DIDN'T BELABOR THE POINT BUT I DID GO TO THE BALTIMORE CITY HEALTH COMMISSIONER WHO I'VE BEEN DYING TO MEET AND REMINDED HER OF 'KOOL SMILES' DENTISTRY HERE IN BALTIMORE AND BEING PROSECUTED IN SEVERAL STATES FOR MASSIVE FRAUD AND PATIENT ABUSE. THIS COMANY IS JUST ONE EXAMPLE OF MANY OF COURSE. DR. BARDOT QUICKLY AVERTED HER HEAD AT THE MENTION OF FRAUD.....ONCE SHE HEARS THESE CLAIMS SHE IS COMPLICIT YOU KNOW......I ENDED WITH
WE DON'T WANT OUR MOST VULNERABLE TO HAVE THE WORST CARE! WHICH THEY DO WHILE THINKING I DON'T WANT THIS TO BE MY MEDICARE!
Commissioner of Health
Oxiris Barbot, M.D.
YOU CAN SEE WITH ALL THE TAX CREDITS AS INCENTIVES THEY ARE LOOKING FOR BUSINESSES AND NOT FOR A COMMUNITY ORGANIZATION. WHAT WILL HAPPEN IS THEY WILL DO THE SAME WITH HEALTH CARE AS THAT BUILDING WITH ALL THE MEDICAID DENTISTS KEEPING PEOPLE OUT OF MAINSTREAM CARE. AS SOON AS THEY FINISH THIS.......IF WE ARE NOT SUCCESSFUL IN STOPPING THEM........THEY WILL HAVE MEDICARE PATIENTS FOLLOWING SUIT......OUT OF PRIVATE DOCTOR'S OFFICES AND INTO COMPOUNDS.
What is a HEZ?
Chapter 3 (Senate Bill 234) of 2012 (http://mlis.state.md.us/2012rs/chapters_noln/Ch_3_sb0234T.pdf) establishes a process whereby the Secretary of the Department of Health and Mental Hygiene (DHMH), in collaboration with the Community Health Resources Commission (CHRC), will designate Health Enterprise Zones (HEZ). The purpose of these zones will be to reduce health disparities, improve health outcomes, and reduce health costs and hospital admissions and readmissions in specific areas of the State.
For an HEZ to be designated by the Secretary, a non-profit community-based organization or local health department must apply to DHMH and CHRC with a comprehensive plan to address disparities in a defined geographic area. The bill contains several possible incentives that can be utilized to address disparities within the HEZ including:
- Loan assistance repayment;
- Income tax credits;
- Priority to enter the Maryland Patient Centered Medical Home Program;
- Grant funding from CHRC; and
- Priority for receiving funds for establishing an electronic health records program.
The FY 2013 budget allocates $4 million to the Community Health Resources Commission to fund the HEZ’s.
YOU CAN SEE FROM THIS ARTICLE THAT THE IDEA OF ENTERPRISE ZONES COMES STRAIGHT FROM CONSERVATIVE THINK TANKS. IT IS FUN TO SEE THE CONSERVATIVE LAMENT HOW THE IDEA WENT FROM BUILDING POOR COMMUNITIES FOR THE POOR TO PRETENDING TO BUILD FOR THE POOR AND BUILDING LUXURY COMMUNITIES TO EXPLOIT THE POOR. THIS AUTHOR RECOGNIZES THE SAME WILL HAPPEN WITH THESE HEALTH ENTERPRISE ZONES.
VOTE YOUR INCUMBENT OUT!!!!!!!
Maryland's Health Enterprise Zones Need The Right Incentives And Rules
By Stuart Butler, Ph.D. February 23, 2012
As an architect of the urban "enterprise zone" idea more than 30 years ago, a recent proposal in Maryland to set up Health Enterprise Zones (HEZ) understandably caught my eye. The original enterprise zone was designed to spur economic activity in depressed neighborhoods through reduced local taxes and regulation, together with federal and state tax incentives to encourage investment. The aim was to grow innovation and reduce obstacles to both local and outside entrepreneurs. Several states have created these zones, and a federal version was enacted under President Bill Clinton.
The Maryland HEZ proposal is similar in its approach. The bill -- which was unveiled by state Lt. Gov. Anthony Brown and based on recommendations from an expert panel -- works to expand health services in the state's underserved areas. If enacted, available properties would become inexpensive, and medical providers would receive property and income tax breaks to set up shop in these zones. Plus, the health zones could receive additional, targeted funding. And, dovetailing with the health enterprise zones, the state would create a Maryland Health Innovation Prize.
I'm struck by the similarities in the strategies these two forms of enterprise zones enlist, which is why Maryland's HEZ is an important initiative. By definition, depressed or underserved areas lack adequate resources for their population. And medical providers -- who are often burdened with high student loans and their own needs -- are reluctant to practice there. But the right tax incentives, along with easier access to inexpensive medical facilities and lower start-up costs, can make the venture more worthwhile for providers. The early enterprise zones focused on the zoning, building codes and the removal of tax liens on available property for the same reason: to encourage new ventures and business investments.
Steering contracts, such as for electronic medical records, as well as new money for the HEZ program into these medically underserved areas is probably needed. But the experience in urban economic development -- from the Model Cities program of the 1960s to today's generous corporate infrastructure and other city-offered benefits -- suggests some caution. When local or state governments are distributing funds, the type of development often ends up benefiting well-connected interests rather than addressing the needs of local residents in the most effective ways. Indeed, enterprise zones, with their emphasis on deregulation and tax reductions rather than direct funding, were in many ways the mirror image of the heavily funded Model Cities projects, which often resulted in expensive buildings but little impact on local poverty.
To avoid this pitfall, the health enterprise zones should keep a strong focus on how to reduce expensive barriers to the availability and creative use of private health resources. To be successful, Maryland's program should include steps to pare back regulations. For instance, it would make sense to suspend the Certificate of Need requirements in a health enterprise zone, or at least simplify them. These certificates are required before medical facilities can be built or acquired in states like Maryland, and obtaining these certificates can be a long and costly process.
Similarly, there must be a focus on zoning and other land-use rules, such as regulations affecting public housing. Often, incorporating health services in depressed and underserved areas requires the ability to transform vacant public housing units into walk-in clinics. Land-use red tape typically slows down the process.
An effective health enterprise zone also would need to modify state rules for government health programs like Medicaid, so that health providers are rewarded for innovative services. For example, Denver Health in Colorado operates a highly effective nurse-run, 24-hour call center for families that can address their needs quickly and send prescriptions to close-by pharmacies. This has reduced emergency room costs and handled residents' health concerns quickly in areas that do not have any nearby medical facilities. But Medicaid's payment rules usually do not reward such initiatives.
Maryland's health enterprise zone program should consider establishing a zoning board of medical and local neighborhood leaders who can continuously identify regulations and program rules that get in the way of providing services quickly and creatively in poor and underserved neighborhoods. The state also should agree, in advance, to streamline the process by which such regulations could be changed or eliminated. My experience from urban enterprise zones suggests that there will be no shortage of recommendations.
Stuart Butler is the director of the Center for Policy Innovation at The Heritage Foundation.
Send this report to a friend Your Information Yes, I'd like to receive news about Heritage via email Your Friend's Information Your Message First appeared in Kaiser Health News
THIS IS WHERE WE SEE MEDICARE PATIENTS MOVING INTO THE PICTURE. THESE PEOPLE DON'T INTEND HAVING RETIREMENT COMMUNITIES OR NURSING HOMES FOR THE ELDERLY TO CHOOSE...COMRADERY AND SPECIALIZED INFRASTRUCTURE.....THEY SEE MOST OF US LEFT AT HOME. NBC NEWS HAD A PIECE ON HOME HEALTH ROBOTS THAT CHECKED VITAL SIGNS AND WATCHED THE SENIOR CITIZENS WITH COMPUTER CAMERAS. WHEN SOMEONE SAID THAT WAS PRETTY INVASIVE IN PEOPLE'S LIVES......THE DOCTOR SAID 'GET OVER IT'!
THINK OF HOW MANY PEOPLE GO TO ASSISTED CARE NOW AND WHAT IT WILL LOOK LIKE WHEN YOU ARE HOME LOOKING AT A DOCTOR THROUGH A COMPUTER. SOME SENIORS LIKE THE IDEA OF LIVING WITH CHILDREN....MANY DON'T OR CAN'T. THIS WILL NOT END WELL.
DHMH AND HEALTH CARE PARTNERS CELEBRATE FUNDING FOR LONG-TERM SERVICES AND SUPPORTS FOR MARYLANDERS IN NEED
by System Account on 7/18/2012 2:21 PM BALTIMORE, MD (July 18 2012) -
The Maryland Department of Health and Mental Hygiene (DHMH) and health care partners today celebrated the State's commitment to use $14.3 million generated by the 2011 alcohol tax increase to expand long-term services and supports (LTSS) to frail seniors and adults with disabilities living in the community.
"Keeping seniors and those with disabilities in their communities and closer to their families leads to a higher quality of life," said Lt. Governor Anthony G. Brown, who leads the O'Malley-Brown Administration's health care portfolio. "These funds will help us expand access to home and community-based care so more Marylanders who need critical health services can remain in their homes and out of institutions." During an event at AARP Maryland in Baltimore, Health Secretary Joshua M. Sharfstein, M.D., joined AARP State Director Hank Greenberg and Maryland's Health Care For All! Coalition President Vincent DeMarco in celebrating the $14.3 million that will be used to fund home- and community-based long-term care for Marylanders in fiscal 2013. With those funds, 480 more people with physical disabilities and older adults will be able to stay in their home and receive the services they need rather than enter an institution, and others will receive additional support.
"Marylanders with disabilities and older adults deserve to get the services they need in their own homes," Secretary Sharfstein said. "Rebalancing the LTSS budgets has been a critical initiative for our department." THIS TAX MONEY FOR THE DISABLED WAS A GOOD THING.
For fiscal 2013, which started July 1, Governor O'Malley and the General Assembly allocated $64 million of the alcohol sales tax increase money to needs outlined by the Lorraine Sheehan Alcohol Tax Coalition, including $14.3 million for Rebalancing to expand and strengthen community-based services and reduce the need to rely on institutions for long-term care.
"Improving home and community-based long-term care is a terrific use of the revenue from the life-saving 2011 alcohol sales tax increase," said Vincent DeMarco, president of the Maryland Health Care For All! Coalition. "We commend the O'Malley Brown Administration for using almost all of the revenue raised by that tax for the health care and community service needs outlined by the Lorraine Sheehan Alcohol Tax Coalition."
In March 2012, the federal government awarded $106 million to Maryland, the largest federal Balancing Incentive Program grant to date under the Affordable Care Act to promote LTSS community rebalancing. Maryland is working with AARP Maryland and other stakeholders to reach the State's goal of spending at least half of all LTSS dollars in community-based care by the end of 2015.
"AARP members overwhelmingly prefer to have the option to age in place - at home or in the community, said Hank Greeenberg, AARP state director. "Maryland has made a major shift toward that end this year, thanks to the Governor and Secretary Sharfstein. AARP is very proud to be part of the diverse coalition that made this happen. We look forward to building on this success."
Rebalancing ($14.3 million)
Expand and strengthen community-based services and reduce the need to rely on institutions for long-term care:
HERE IN MARYLAND O'MALLEY AND STATE LEGISLATOR'S FIRST STEP AFTER THE SUB-PRIME LOAN CRISIS WAS TO REDUCE THE YEARS A CORPORATE FRAUD CAN BE PROSECUTED FROM 5 TO 3 YEARS........MASSIVE FRAUD LEADS YOUR ELECTED OFFICIAL TO MAKE IT HARDER FOR YOU AND I TO RECOVER FRAUD. THIS IS WHAT THIRD WAY CUOMO IS DOING IN NEW YORK AND IT IS WHY THE OBAMA ADMINISTRATION HAS FAILED TO DOUBLE-DOWN ON HEALTH CARE FRAUD.........THESE POLITICIANS ARE NOT LISTENING TO ALL THE CALLS TO REFORM THIS FAILURE TO ENFORCE LAWS.....THEY ARE WIDENING THE OVERSIGHT NEGLECT! ALL OF THESE POLITICIANS HAVE NO PROBLEM WITH CUTTING YOUR BENEFITS THOUGH! THE SAME WILL HAPPEN WITH HEALTH CARE REFORM.......MASSIVE FRAUD ALREADY HAPPENING. O'MALLEY ALWAYS FOLLOWS CUOMO'S LEAD.
Under Pressure, New York Moves to Soften Tough Medicaid Audits
Nathaniel Brooks for The New York Times
James C. Cox, New York’s new Medicaid inspector general, has said he intends to pursue a less “adversarial” auditing strategy.
By NINA BERNSTEIN Published: March 18, 2012
New York State was paying for the medical care of dead people when Gov. George E. Pataki and the State Legislature created the Office of the Medicaid Inspector General to curb billions of dollars in fraud and misspending by health care providers.
The turnaround was startling. Within four years the state had recouped $1.5 billion in Medicaid overpayments, the highest recovery rate in the nation. Other states rushed to create inspectors general like New York’s.
But a backlash from the politically powerful health care industry has erased broad support for the crackdown. Last year, amid a crescendo of provider complaints of overzealous, nitpicking audits and unfair tactics, Gov. Andrew M. Cuomo quietly dismissed the state’s first Medicaid inspector general, James G. Sheehan, and directed Mr. Sheehan’s successor, James C. Cox, to collaborate with providers on changes to the agency’s policies and auditing methods.
In an interview, James Introne, Mr. Cuomo’s deputy secretary for health, expressed the state’s new view.
“An audit need not be an adversarial enterprise,” Mr. Introne said. “To the extent that an audit turns into an adversarial affair, it may not be conducted properly. An audit is successful when people agree.” AN AUDIT IS WHEN THE PERSON BEING AUDITED HAS NOTHING TO DO WITH IT!!! THINK IRS. WHAT THEY ARE SWITCHING TO IS JUST LIKE THE NEGOTIATED SETTLEMENTS WITH THE BANKS.....PENNIES ON THE DOLLAR OF FRAUD WITH NO PROSECUTION OR ADMISSION OF GUILT.
The Cuomo administration said that enforcement was as vigorous as ever, and that Mr. Cox was on target to avoid $1.1 billion in improper Medicaid spending this year, even more than his predecessor. But veterans of Medicaid policing pointed to important audits that were started by Mr. Sheehan but have not been released, and said the inspector general’s office was at a difficult crossroads, caught between the Legislature’s allegiances to campaign contributors from the health care field and the governor’s plans to cut Medicaid costs, which depend on the goodwill of nursing homes, hospitals and home health agencies.
“An industry that’s regulated doesn’t love the regulator unless the regulator isn’t doing much,” said Arthur A. Levin, the longtime director of the Center for Medical Consumers, a nonprofit advocacy organization, who admired Mr. Sheehan. “Asking the regulator and the regulated party to sit down and come to some sort of consensus on how the regulation should be — to me, it makes no sense.”
Michael A. Zegarelli, a past president of the national association of Medicaid oversight officials and a senior regulator in New York until 2003, said that by definition, an audit that found overbilling, fraud or waste was “going to be adversarial.”
“Sheehan’s successor will have a short leash,” Mr. Zegarelli said. “Will that be for the benefit of the program, or to keep Cuomo’s constituency happy?”
New York’s Medicaid program, jointly financed by federal, state and local taxpayers, is the nation’s largest, at $53 billion. In 2005, an investigation by The New York Times found that Health Department regulators had uncovered only 37 cases of suspected fraud in 400 million annual claims, overlooking red flags like a storefront dentist whose billings spiked to 991 procedures daily and a nursing-home operator who took in $1.5 million in salary and profit the same year he was fined for neglecting the home’s residents. THINK MARYLAND'S LOOKS LIKE THAT NOW!!!! I BETCHA.
The 2006 overhaul spurred by that investigation was financed by a $1.5 billion payment from the federal government with tough terms: the state had to recoup the money by September 2011 or pay back the shortfall. To take charge, Gov. Eliot Spitzer in 2007 appointed Mr. Sheehan, who had prosecuted health care fraud for 20 years as an assistant United States attorney in Philadelphia. WE MAY WANT TO OVERLOOK THE PROSTITUTION CHARGES FOR A REAL PROGRESSIVE IN SPITZER. SPITZER FOR PRESIDENT!!!
Mr. Sheehan exceeded recovery targets. Over all, the state reclaimed 1.2 percent of its total Medicaid spending, the nation’s highest rate.
But complaints from providers mounted, and were taken up by legislators. The providers charged that under pressure to meet the federal target, Mr. Sheehan treated paperwork errors like fraud. At one legislative hearing, he was accused of “gangster tactics” for demanding that providers settle with the state or risk having to pay more based on findings extrapolated from statistical samples.
“Jim Sheehan was able to make up his own rules,” said Richard J. Herrick, president of the New York State Health Facilities Association, a nursing-home trade group. “It wasn’t for purity, it was where can we find money to recoup.” PURITY???
In June, Mr. Sheehan was dismissed with a month’s notice in a phone call from Mr. Cuomo’s director of operations.
“He said, ‘We’ve decided to go in a different direction,’ ” recalled Mr. Sheehan, who has since been hired as the chief integrity officer and executive deputy commissioner for the Human Resources Administration, which oversees Medicaid in New York City.
A spokesman for the Cuomo administration would not specify the reasons for the decision, and Mr. Sheehan said that as a political appointee, he had no problem with it. But he disputed providers’ accusations, saying that the real issue was his challenge to a powerful industry that is a large employment engine.
“Medicaid is to New York what corn is to Iowa,” he said. “It’s a heavy lift.”
He said that audits of nursing homes, for example, found that some had inflated their profits by needlessly sending every patient to physical therapy during the month when annual reimbursement rates were calculated.
The nursing-home trade group sought an injunction to stop the audits. A court dismissed the association’s argument that Mr. Sheehan had exceeded his jurisdiction.
Mr. Herrick said that the decision was on appeal, and that his association was revising audit protocols with Mr. Cox, the new inspector general. “I have no personal knowledge that facilities followed the practice alleged,” he said, “and as a practical matter find it highly unlikely.”
In home health care agencies, Mr. Sheehan said auditors found widespread patterns that violated Medicaid requirements linked to quality of care.
“Nurses are supposed to review the work and design the plan of the home health aides, but there were cookie-cutter plans,” he said, citing one plan that failed to mention that the patient was an amputee or to explain how the aide was to care for the stump.
“Home health aides would not show up, or would be in two places at once,” he added. “One entity billed us 500 times for home health care while patients were in the hospital.”
Mr. Sheehan would not name audited agencies, but two of his former managers said the largest audit was of Visiting Nurse Service of New York, a $1 billion nonprofit group. That audit gained attention a year ago, when an internal report citing tens of millions of dollars in overpayments was leaked to The Wall Street Journal. At the time, the agency’s chief executive was on a task force advising the new governor on how to redesign Medicaid to trim costs.
Richard Rothstein, a spokesman for Visiting Nurse Service, said that under an agreement with the inspector general’s office, he could not talk about the audit, which started in 2008 and has not been released. But he added, “There is absolutely no discussion about fraud,” only “errors in paperwork.”
One example cited in the preliminary report was a bill for an eight-hour-long sponge bath. Mr. Rothstein said that there had been no intent to cheat Medicaid and that the aide who started the sponge bath had forgotten to report that a nursing crisis had intervened before she finished it hours later.
Many providers welcomed Mr. Sheehan’s exit, but Richard J. Mollot, executive director of the Long Term Care Community Coalition, which advocates for nursing-home residents, did not.
“It was politics at its worst to see him leave,” Mr. Mollot said. “They put enormous pressure on that office to sustain their budget, so to then turn around and say they were too aggressive is the height of hypocrisy.”
After Mr. Sheehan’s dismissal, lawmakers unanimously passed a bill curbing the office’s authority. It cut the government’s time to reclaim overpayments to three years from six and let providers submit corrected bills rather than repay. JUST LIKE THE BANKS
Mr. Cuomo, an aggressive prosecutor of Medicaid fraud as attorney general, vetoed the bill. “The provider community, as a whole, plays a critical role,” his veto message said, “and many of their concerns reflected in this bill are legitimate.” But, he added, the bill “would potentially allow fraudulent and abusive activity to go undetected or unprosecuted.”
Instead, he ordered Mr. Cox to review policies with “a working group comprised of representatives of provider associations and others.”
Mr. Cox’s confirmation last week, after a nine-month wait, underscored the change in climate. At genial committee hearings, state senators said they were receiving positive feedback from providers, but one warned that the vetoed bill would be resubmitted “if we hear otherwise.”
Mr. Introne, the deputy health secretary, said that Medicaid providers followed rules better now than they did five years ago. Mr. Sheehan agreed, and said his successor was well-qualified. But he noted that dozens of city audits he had asked to start or to release in his new job were still awaiting Mr. Cox’s approval.
Audit figures released by the state show that Mr. Cox’s findings of overpayments have fallen steeply since Sept. 30, when the state met the deadline for the $1.5 billion federal target.
Mr. Cox, a 23-year veteran of audits for the Health and Human Services inspector general, said he involved government lawyers and providers at the outset of an audit and examined every audit himself to make sure its findings could withstand a court challenge. That has held up some audits, he acknowledged, including that of Visiting Nurse Service, which is “still being reviewed and discussed with the entity and its lawyers to see what areas we agree on or disagree on.”
“We’re all about fighting fraud,” he said, and “also about improving program integrity, quality of care, and saving taxpayer dollars. That’s our mission, and we’re sticking with it OH, YEAH!!!! WE'LL BE WATCHING.