In 2018 the Federal Bureau of Investigation and the NYC Department of Investigation arrested eight service providers for Health Care fraud, as well as other felonies related to Fraud. Unfortunately, last month another case came to light involving nine therapists that were arrested for stealing more than $3 million from the New York State Early Intervention Program (“EI”). As a result of these cases, the New York City Early Intervention Program, the Provider Oversight Unit of the BEI will be conducting audits of the fraud prevention measures currently being used by each EI agency serving families in NYC.
Fraud Prevention Checklist
According to the NYCBEI, stopping therapist fraud should be the priority of all EI provider agencies, and it is expected that agencies have implemented proper fraud risk controls to assess, detect, and prevent the risk of fraud. As a result, the BEI has released a Fraud Prevention checklist made up of 15 fundamental measures that EI agencies can, and should, take to prevent/identify fraud.
The checklist is simple to fill out. Providers should indicate yes or no when asked if they have a specific measure in place. Providers must provide supporting documentation to prove that the measure is implemented.
While there is no scoring given for this audit, the NYC BEI will be providing feedback and suggestions for strengthening these measurements to reduce the overall risk of fraud.
This checklist is due December 24th, 2021, there will be no extensions, and failure to submit will be considered a violation of an agency’s requirement to cooperate with oversite activities
The completed form and all attachments should be sent via email to POREVIEW@health.nyc.gov by 5:00 pm on Friday, December 24, 2021.
Fraud Prevention Q&A Sessions
The NYC BEI Provider Oversight Unit is hosting three Fraud Prevention Q&A Sessions to answer questions agencies may have about the Fraud Prevention Checklist. These three sessions are co-sponsored by the Inter Agency Council of Developmental Disabilities Agencies, Inc., the NYC Coalition for Children with Special Needs, and Agencies for Children’s Therapy Services (ACTS). There will be an opportunity for agencies to submit their questions before and during the sessions.
Each 90-minute Fraud Prevention Q&A Session will start with a short overview of how fraud is committed, followed by a discussion of the 15 measures and responses to the most frequently asked questions.
Sessions will be held three times over a two-week period.
o Wednesday, December 1, 2021, 2:00 -3:30pm
Albert Borghese, CPA
Manager
