New York City and a contracting company are accused of a massive Medicaid fraud scheme relying on automated software.
Federal prosecutors are suing New York City and Computer Sciences Corporation (CSC) for tens of millions of dollars in alleged Medicaid fraud stemming from a five-year effort to bilk the agency out of reimbursements for young children who benefited from the program. The office of Preet Bharara, the US District Attorney for the region covering the city, has accused CSC and the Department of Health and Mental Hygiene of switching diagnosis codes, falsifying claims, and circumventing reimbursement policies in order to collect unauthorized funds.
“As alleged, CSC and the City created computer programs that systematically, and fraudulently, altered billing data in order to get paid by Medicaid as quickly as possible and as much as possible,” Bharara said in a public statement. “Billing frauds like those alleged undermine the integrity of public healthcare programs like Medicaid. All public healthcare program participants, whether they are healthcare providers, localities like the City, or contractors like CSC, should understand that they must comply with the applicable billing rules.”
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