James C. Cox Rumored to Succeed James Sheehan as Medicaid Inspector General

After reports a few weeks ago that James Sheehan had been asked to resign from his position as Medicaid Inspector General for the State of New York, rumors began circulating as to who would succeed him.

Some believed that Governor Andrew Cuomo would appoint a former colleague from the Attorney General’s Medicaid Fraud Control Unit, while others predicted the appointee would be an individual with experience on the provider side.  The Public Health Law requires that the Medicaid Inspector General have at least ten years of experience “in one or more of the following areas of expertise: law, provided the experience involved prosecution or some consideration of fraud; fraud investigation; and auditing.”

Today, speculation is coming to an end.  Rumors have surfaced that Governor Cuomo has named, or will soon name, James C. Cox to replace Mr. Sheehan.  Mr. Cox was formerly with the United States Department of Health and Human Services, Office of the Inspector General (OIG) and served as the Regional Inspector General for Audit Services in Chicago, Illinois.  He has also served in the OIG’s Albany, New York office.

David R. Ross, Esq., Of Counsel for O’Connell and Aronowitz, said: “We look forward to working with Mr. Cox should he be appointed by the Governor and confirmed by the Senate, and we wish him well in his new role which will undoubtedly bring many challenges.”  Mr. Ross previously served as Acting New York State Medicaid Inspector General under Governors Pataki and Spitzer.

Mr. Sheehan, a former federal prosecutor appointed by Governor Spitzer, gained a reputation as an aggressive Medicaid enforcer by expanding the concepts of fraud and abuse within Medicaid to include simple technical errors.   Not coincidentally, the New York State Legislature, as we previously reported, recently passed new legislation that would, if signed into law by Governor Cuomo, significantly impact the powers of the Office of the Medicaid Inspector General by protecting Medicaid providers from certain audit practices.