Medicaid fraud back in news"
State Senator George Winner Jr.

"EX-NYERS RIPPING OFF MEDICAID MILLIONS"

That was the headline on a recent investigative report in the New York Post detailing how auditors from the state comptroller's office have found that, from November 2006 to November 2007, thousands of former New York State residents (nearly 30,000 former New York City residents alone) were still collecting New York Medicaid payments while enrolled in another state's Medicaid program — a violation of state regulations.

It's enough to drive you crazy.

No, let me rephrase that: it's a clear rip-off of state taxpayers to the tune of tens of millions of dollars, maybe more. According to the recent Post report, the comptroller's audit reveals that "in one year alone, $30 million was spent on Medicaid services for (New York) city residents living out of state." Unbelievable. It forces us to ask, How can it happen? Where's the watchdog?

It's likely to reignite what's been a criticism spanning the four decades since the beginning of New York's Medicaid program in 1966, a program that cost approximately $102 million in its first year and costs more than $46 billion today. Medicaid has become our most costly health care program, and, sadly, it remains a system plagued by abuse, fraud, and waste.

I can fully attest to this ineffectiveness because I've joined a small cadre of legislative colleagues, year after year, in the fight to reform Medicaid. To warn that its ever-escalating costs threatened the downfall of hardpressed communities. To warn that local property taxpayers would someday be crushed under the Medicaid burden. To warn that it was a system fraught with abuse. The Medicaid reform debate would flare up occasionally, but mostly these repeated warnings fell on deaf ears.

But we never stopped fighting. We were joined in 2004 by an effective grassroots Medicaid reform campaign led by local leaders including Chemung County Executive Tom Santulli and Steuben County Administrator Mark Alger. The fight produced a cap on local Medicaid expenses in 2005, a cap that's already being credited with helping to hold down local property tax increases in counties locally and statewide.

But the cap on local Medicaid expenses was only the first blow. We needed to keep fighting, because New York's property taxes remain 50 percent above the national average and the high cost of Medicaid remains a large part of the reason why.

So we resumed the fight in 2006 to recognize that our system of Medicaid was fraught with ineffectiveness, abuse, fraud, and waste - all of which was costing property taxpayers statewide billions of dollars, to mention nothing of how it sapped the quality of health care for millions of New Yorkers. The Senate successfully fought for the establishment of a new, independent Office of Medicaid Inspector General.

Now we need for that office to be fully up to speed. A good place to begin may just be with an all-out investigation of the recently exposed fraud where, it appears, thousands of former state residents continue to collect New York Medicaid payments while enrolled in other states' Medicaid programs. And, indeed, State Inspector James G. Sheehan has ordered a far-reaching probe, the results of which will be eagerly awaited in the Legislature.

It's high time that our Medicaid program stops getting into the pockets of local taxpayers for billions of dollars annually. We expect the new, independent Medicaid Inspector General to put an end to the waste that has defined our Medicaid system for far too long. This new office must produce a dramatic reorganization of the state's process of preventing, detecting, investigating, and recovering improper Medicaid payments, and combating fraud and abuse within the program.

If done right, we believe the office could produce billions of dollars in annual taxpayer savings and greatly improve the accountability, integrity, and quality of New York's $46-billion Medicaid program.

Those savings can't arrive too soon.