Tougher Medicaid Fraud Effort Needed To Stop Abuse And Save Tax Dollars
March 8, 2010
(New York,N.Y.)-District Attorneys, County Executives, County Comptroller, Medicaid Fraud Technology Specialists Join Senate Republicans at Albany Medicaid Fraud Task Force Public Forum
The Senate Republican Task Force on Medicaid Fraud conducted a public forum today in Albany to investigate what savings can be gained from New York’s overburdened Medicaid system. The Taskforce will explore ways in which the State Legislature can assist counties to improve Medicaid fraud prevention efforts.
Chaired by Senator Kemp Hannon (R-C-I, Garden City), the Taskforce will develop recommendations for improving the State’s Medicaid system.
Among those providing expert testimony today were Nassau County District Attorney Kathleen Rice, New York State Association of Counties President Thomas J. Santulli, District Attorney’s Association of New York President Kathleen Hogan, Rensselaer County Executive Kathleen Jimino, Albany County Comptroller Mike Conners and Medicaid fraud technology specialists.
“There is no excuse for tolerating any fraud in a program that is the fastest-growing and largest single component of state and county budgets,” said Senate Republican Leader Dean Skelos. “Medicaid fraud drives up state spending and taxes as well as local property taxes. We must fight fraud aggressively, restore accountability and integrity to the Medicaid program, and ensure that tax dollars are spent wisely to help the people who really need help, not enrich criminals who prey on the system.”
Along with Senator Hannon, the task force includes Senators George Winner (R-C-I, Elmira), Charles Fuschillo (R, Merrick), Michael Nozzolio (R-C, Fayette), Mike Ranzenhofer (R-C-I, Amherst), Hugh Farley (R-C, Schenectady), Martin Golden (R-C, Brooklyn) and Vincent Leibell (R-C-I, Patterson).
“Medicaid costs New York State taxpayers a billion dollars per week,” said Senator Hannon. “This means it is costing taxpayers over fifty-two billion dollars per year.”
Chemung County Executive Thomas J. Santulli, President of the New York State Association of Counties, said, “We need to have all levels of government working together so that scarce public funds are used as they are intended to be. Our counties know what works in the program and what doesn’t, and there may be areas of fraud and abuse. Recently, New York City and forty-two New York Counties obtained a victory in federal court against 13 pharmaceutical manufacturers for fraudulent pricing through the Medicaid Program. These types of actions continue to demonstrate the relevance and importance of county governments ensuring the integrity of the Medicaid Program in New York.”
“In the future, our desired objective must include the implementation of a cost-effective and efficient method of delivering Medicaid services to our seniors and those citizens who are most in need, while also trying to lessen the burden on the taxpayer,” added Senator Hannon.
The widespread problem of Medicaid fraud has been highlighted by several reports issued by the State Comptroller’s office that documented millions of dollars in Medicaid overpayments and billing errors, as well as tens of thousands of people that were improperly enrolled in Medicaid in New York City.
Despite the fact that they are on the front lines of the Medicaid program, county officials are saying the state hinders their efforts to stop fraud at the local level. In fact, the 2009-10 State Budget approved by the Governor and Democratic Legislators eliminated the eligibility requirements for county-conducted face-to-face interviews, finger-imaging and asset tests for Medicaid applicants, conducted by counties. The interviews are intended to ensure accountability in the system, but will no longer be required as of April 2010.
“This Task Force will dig deep to find solutions to protect state taxpayers from a system that remains vulnerable to fraud and abuse,” said Warren County District Attorney Kathleen Hogan, who is also the President of the New York State Association of District Attorneys. “Through its efforts, the members of the Task Force will combine extensive knowledge and experience in the continuing battle to combat Medicaid fraud.”
The Executive Budget proposes spending a total of $52.5 billion on Medicaid, meaning as much as $5 billion could be fraud in the system.
In 2006, the Governor signed into law legislation sponsored by Senators Skelos and Hannon, which:
- Created a new, independent, Office of Medicaid InspectorGeneral by consolidating responsibilities and staff from six agencies into the new Office and empowering the Medicaid Inspector General with the ability to detect, investigate and recover improper Medicaid payments;
- Provided county governments with new incentives and access to information to become active partners in the fight against Medicaid fraud;
- Enhanced the capacity of the Department of Health and Office of Medicaid Inspector General to fight fraud with new, state-of-the-art technology;
- Established new protocols and procedures to ensure the effective sharing of information and evidence regarding Medicaid fraud between the Office of Medicaid Inspector General, the Attorney General’s Medicaid Fraud Control Unit, county governments and district attorneys;
- Required health care institutions to implement corporate compliance programs and allowing providers to request advisory opinions to ensure proper billing practices, and
- Created new Health Care Fraud offenses to aid in the criminal prosecution of Medicaid fraud.
“We want to make sure that the 2006 law is having as much of an impact as possible,” Senator Skelos said. “This issue becomes even more urgent when you consider reports that the federal government is investigating whether the people who are supposed to be watching out for Medicaid fraud are actually committing fraud themselves.”
In December, the New York State Comptroller released the results of an audit that identified as much as $92 million in Medicaid overpayments, billing errors and other problems. He called on the State Department of Health to increase scrutiny of Medicaid payments and recover payments that were improperly made. The Department agreed there were overpayments, but said it would only try to recover $2.4 million in overpayments.
In addition, a 2008 report in the New York Post cited an audit by the Comptroller’s Office, determining that nearly 30,000 people in New York City alone were improperly enrolled in the State’s Medicaid system between November 2006 and November 2007. While the audit shows that almost 13,000 former New York City residents should have been investigated for violations of the State’s Medicaid laws, only 207 cases were investigated.
In his Executive Budget, Governor Paterson increased the State’s target for Medicaid fraud recovery by $300 million, to a total of $1.1 billion.
Posted by News LI Editor · Filed Under Money
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