175.996 “Pill Mill” Centers:
MSSNY is seeking regulatory or statutory reform mandating that physicians affiliated with Medicaid “Pill Mill” Centers where there is undisputed evidence of Medicaid abuse be subject to an expedited license review and suspension as may be required by the appropriate agencies. MSSNY is seeking to ensure that suspension of any physician’s license be based on direct and verifiable identification of the clinic(s) in question by the appropriate enforcement and investigative agencies and established community organizations, and not solely upon indirect and tangential criteria. Such unacceptable criteria would include, but not be limited to, Medical Management Information Services (MIS) computerized billing records or superficial and unreliable “spot check” site visits productive of only anecdotal and ultimately inadmissible evidence as gathered by the funding agency of the Medical Assistance Program. (Council 1/19/92; Reaffirmed HOD 2014; Reaffirmed HOD 2024)
