Medicaid Waste Another Example of NYS Being Its Own Worst Enemy

By Will Barclay

New York’s unrelenting taxes and a dwindling population, in addition to chronic fraud, abuse and waste, continue to hinder economic growth. The last thing New Yorkers need is to see their own state government wasting money, but that is, unfortunately, what appears to have happened thanks to a newly uncovered Department of Health (DOH) oversight costing more than a billion dollars.

Reports from the Office of the New York State Comptroller indicate the state accidentally distributed $1.2 billion in Medicaid payments to managed care companies for covering individuals who were residing out of state. The enormity of this error is both alarming and disturbing, and so is the fact that it could have been avoided if the DOH had basic vetting and verification practices in place to prevent it.

The improper payments were made, despite the existence of a federal database known as the Public Assistance Reporting Information System, which is designed specifically to identify residents who may be receiving benefits payments from more than one state. Unfortunately, for New Yorkers, the comptroller’s audit found DOH did not begin sending relevant data or conducting reviews on potential duplicate payments until after $1.5 billion had already been sent to unreviewed individuals.

Additionally, Comptroller Thomas DiNapoli’s office found the DOH failed to properly transfer individuals eligible for Medicare off Medicaid, which led to another errant $294.4 million in inappropriate spending, as well as other overpayments and improper expenditures. These are not rounding errors; these mistakes are costing New Yorkers billions of dollars at a time when every dollar matters.   

It is no secret that New York has faced myriad waste and fraud issues in recent years, but the sheer magnitude of these errors threatens to further damage our already fragile health care system. New York state already spends too much on Medicaid, among the most bloated programs in the nation, and we simply cannot afford to send a single dollar to anyone who is not rightfully eligible.

These mistakes must be cleaned up immediately. New Yorkers literally cannot afford any more incompetence.

Will Barclay (R.C.I-Pulaski) is the Assembly Minority Leader.