FacultyFaculty/Author Profile

Jim Sheehan

New York City Human Resources Administration
Chief Integrity Officer
New York, NY, USA

On Monday, October 31, 2011 former New York State Medicaid Inspector General and Associate U.S. Attorney for the Eastern District of Pennsylvania James Sheehan joined HRA as the Agency's Chief Integrity Officer. Mr. Sheehan has direct oversight over the Investigation, Revenue and Enforcement Administration (IREA) and the Office of Audit Services.

Throughout his career, Mr. Sheehan has worked as an attorney with a focus on health care. Most recently, he served as Medicaid Inspector General (MIG) for New York State, from April 2007 to July 2011. As the first to be nominated and confirmed in this position, he was responsible for overseeing professional staff auditors, investigators, nurses, pharmacists and data analytics experts. Creating a new national model for a Medicaid integrity agency, Mr. Sheehan's accomplishments as the NYS MIG included developing the first mandatory compliance program for Medicaid health care providers in the country, which was used as a model for the federal program under the Affordable Care Act; and the increasing the budgeted recoveries and cost avoidances goals for the agency by nearly 300% between 2006-07 and 2010-11.  (Recoveries for 2010-11 totaled $1.2 billion).

Prior to his work for New York State, Mr. Sheehan served for 17 years in the United States Attorney's Office for the Eastern District of Pennsylvania. As Associate U.S. Attorney in Philadelphia, he managed some of the most complex litigation and program innovations and policy, primarily in the areas of prescription drugs, quality of care and predatory lending.

Mr. Sheehan's record of accomplishments and experience span nearly thirty years in investigative techniques and methods used in detecting and preventing fraud and abuse, and comprehensive knowledge of state, local and federal laws, regulations, policies and procedures in the area of fraud. His experience is, and will continue to be, a great benefit to HRA as the Agency works to eliminate fraud and waste and ensure that the public's tax dollars are spent responsibly.


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