The Office of the Medicaid Inspector General is an independent agency within the New York State Department of Health that coordinates the fraud, waste and abuse-control activities of all state executive branch agencies. The office works in conjunction with law enforcement and the Attorney General’s Medicaid Fraud Control Unit.

The Department of Financial Services was created by combining the state Banking and Insurance Departments with the goal of modernizing regulatory oversight of the financial services industry.

The Department of Health’s mission is to protect and promote the health of New Yorkers through prevention, science and the assurance of quality health care. It coordinates health-related programs including tobacco control, obesity prevention, HIV/AIDS education, and the promotion of flu vaccinations. It also administers health insurance programs for low-income New Yorkers and children and EPIC (see below). In addition, it issues an annual report on managed care plans throughout the state, rating specific areas of public health and customer satisfaction.

The New York State Office for the Aging administers programs and services that help older adults maintain their independence with programs on personal care, home and congregate meals, transportation assistance, caregiver assistance, and health promotion and prevention programs. It assists older New Yorkers with navigating the long-term care system and understanding Medicare benefits.

Elderly Pharmaceutical Insurance Coverage (EPIC) Plan provides secondary coverage for prescription drugs to seniors with an annual income under $35,000 (single) or $50,000 (married) who do not receive full Medicaid benefits.

LeadingAge New York, formerly New York Association of Homes and Services for the Aging, is a government watchdog and lobbying group with a focus on health and regulatory issues, and long-term care.

The New York State Coalition for the Aging Inc. believes older adults have the right to live as independently as possible, with dignity, in their homes and communities with the appropriate support services. The group provides advocacy, professional development, leadership skills and education for individuals and organizations serving older adults.

The Healthcare Association of New York State represents and advocates on behalf of New York’s hospitals and health systems at the state and federal level, and with the media.

The Citizens Budget Commission is a nonpartisan, nonprofit civic organization whose mission is to achieve constructive change in the finances and services of New York City and New York State government. The group has released reports including Medicare programs and proposals, and board members have testified on Medicare at various legislative hearings.

The New York StateWide Senior Action Coalition is a grassroots organization composed of individual senior citizens and senior clubs from across New York, with a focus on the needs of low-income and minority seniors.

Selfhelp Community Services Inc. is a home care and senior housing provider in New York City and Nassau County.

The health law practice at Empire Justice Center is focused on providing support for advocates who are helping low-income clients access health care (such as technical assistance and training, and referrals of complex cases) and policy advocacy.

New York State Alliance for Retired Americans is an organization for retired union members with more than 440,000 members in New York state.

New York State Health Foundation (NYS Health) is a private foundation focused on improving the state’s health care system by expanding health insurance coverage, containing health care costs, increasing access to high-quality services and addressing public and community health.

The Visiting Nurse Service of New York is a nonprofit home health care organization composed of 2,600 nurses, 520 rehabilitation therapists, 8,710 home health aides, 575 social workers and 130 other clinical professionals.

AARP, formerly the American Association of Retired Persons, is a nonprofit, nonpartisan organization with a membership that advocates for people ages 50 and older. Since 1958, AARP has lobbied for senior issues, including the passage of Medicare in 1965. AARP offers support from staffed offices in all 50 states, Washington, D.C., Puerto Rico and the U.S. Virgin Islands. The main New York office is in Manhattan.

Wisconsin Physicians Service (WPS) is a Medicare Administrative Contractor (MAC), a company contracted by the CMS to process Medicare claims. WPS processes Medicare Part A and Part B payments and claims for Jurisdiction 5, which consists of Iowa, Kansas, Missouri and Nebraska. WPS also administers Part A and Part B legacy contracts. The Part A legacy contracts are former Mutual of Omaha providers who will eventually transition to Jurisdiction 1 (covered by Palmetto Government Benefit Administrators). They cover Hawaii, Delaware and New York. The Part B legacy contracts cover Illinois, Michigan, Minnesota and Wisconsin.

The Senior Medicare Patrol (SMP) program helps Medicare and Medicaid beneficiaries avoid, detect and prevent health care fraud. The goal is to protect older people and to preserve the integrity of the Medicare and Medicaid programs. The federal program was created in 1996 by the Health Insurance Portability and Accountability Act (HIPAA) and amended in 2006 by Titles II and IV of the Older Americans Act.

Health Insurance Information Counseling and Assistance Program (HIICAP) is part of a national program, known in other states as the State Health Insurance Assistance Program (SHIP), that offers counseling and assistance to people with Medicare and to their families. Coordinators provide counseling on Medicare benefits, Medicare Prescription Drug Plans (Part D), Social Security, Medicaid and veterans' benefits. HIICAP was created under section 4360 of the Omnibus Budget Reconciliation Act of 1990. This act authorized the Centers for Medicare & Medicaid Services (CMS) to make grants to states for health advisory services programs for people with Medicare. HIICAP operates through New York's network of 59 county Area Agencies on Aging.

The long-term care ombudsman advocates for residents of nursing homes and assisted living facilities. The office resolves complaints and educates seniors and long-term care providers about their rights and good care practices. The ombudsman also provides information to the public on nursing homes and other long-term care facilities and services, residents' rights, and legislative and policy issues. In 1978, an amendment to the federal Older Americans Act required every state to have an ombudsman program that addresses complaints and advocates for improvements in the long-term care system. The ombudsman program is administered by the Administration on Aging (AoA).

Quality Improvement Organizations (QIOs) are private, mostly not-for-profit organizations, staffed by doctors and other health care professionals, who are trained to review medical care, to help beneficiaries with complaints about the quality of care and to implement improvements in the quality of care available throughout the spectrum of care. QIOs are required under Sections 1152-1154 of the Social Security Act.

The Area Agencies on Aging (AAA) were established under the Older Americans Act (OAA) Comprehensive Services Amendments in 1973 to respond to the needs of Americans 60 and older in every local community. The amendments added a new Title V, which authorized grants to local community agencies in every state. The AAAs provide a range of options that allow older adults to choose the home- and community-based services and living arrangements that suit them best. New York has 59 offices across the state.

Bradford C. Berk was named CEO of the University of Rochester Medical Center in August 2006 after serving as chief of cardiology and director of the Center for Cardiovascular Research in the Aab Institute for Biomedical Sciences since 1998. He received his medical and doctoral degrees from the University of Rochester School of Medicine and Dentistry.

Joseph D. McDonald is president and CEO of Catholic Health, which oversees Sisters of Charity Hospital, and is chairman of the Board of Trustees of the Healthcare Association of New York State. He began his career in Knoxville, Tenn. He joined Catholic Health in 2002.

Robert I. Grossman joined NYU Langone in 2001 as the Louis Marx Professor of Radiology and chairman of the Department of Radiology. He received his bachelor’s degree in Biology from Tulane University and a medical degree from the University of Pennsylvania.

Louis A. Shapiro was named president and CEO of Hospital for Special Surgery in August 2006 after serving as executive vice president and clinical enterprise chief operating officer of Geisinger Health System in Danville, Penn. Shapiro graduated from the University of Pittsburgh’s College of Arts and Sciences, and earned a master’s degree in health administration from the University of Pittsburgh’s Graduate School of Public Health.

In 2006, Mark Clement became president and CEO of Rochester General Health System, which runs Rochester General Hospital. Clement holds a bachelor’s and master’s degree from Xavier University.

Donald L. Trump came to Roswell Park Cancer Institute in 2002 as senior vice president for Clinical Research and chairman of the Department of Medicine. He became CEO in 2007. Trump earned his medical degree from the Johns Hopkins University School of Medicine in 1970.

Angelo G. Calbone joined Saratoga Hospital in 2006 after serving as president and CEO of Mount St. Mary’s Hospital and Health Center in Lewiston, Maine/Niagara Falls, N.Y. for nine years. Calbone holds a bachelor’s degree from West Liberty State College and a master’s degree in health services administration from George Washington University.

Steven P. Boyle became St. Peter’s Hospital’s president and CEO in 1994 after serving as vice president and chief operating officer since 1988. Boyle holds an MBA.

Scott Batulis has been president and CEO of Orange Regional Medical Center since 2007. Previously, he held various management positions for nearly 20 years with HealthEast Care Systems in St. Paul, Minn. Batulis holds a bachelor’s degree in long-term care administration from the University of Minnesota and an MBA from the University of St. Thomas in St. Paul.

Kenneth L. Davis was appointed CEO of Mount Sinai Medical Center in 2003 after serving as chairman of its Department of Psychiatry for 15 years. He also served as dean of the Mount Sinai School of Medicine from 2003 to 2007. He attended Mount Sinai School of Medicine and completed a residency and fellowship in psychiatry and pharmacology at Stanford University Medical Center.