State's Medicaid Faces Audit
House Panel Seeks Federal Review After $15B in Overbilling
ByJames M. Odato Albany Times Union February 14, 2013
ALBANY - A congressional panel made a bipartisan request Thursday for federal auditors to examine New York state's $54 billion Medicaid spending and fraud oversightprograms.
The audit recommendation was triggered by findings of theU.S. House of Representatives Committee on Oversightand Government Reform that New York overbilled the federal government $15 billion on its developmentally disabled patient facilities. It said the state must repay an appropriate amount of thefunds.
The panel's report questioned multiple cases of huge overcharges by the state for various services, and the operations of the stateOffice of Medicaid Inspector General, which is supposed to investigate misuse of taxpayerfunds.
The report details historic problems with the state's Medicaid program and recognizes that Gov.Andrew Cuomoinherited a bloated and inefficientsystem.
Fraud, waste, abuse and mismanagement has permeated the Medicaid program for decades, the report said. Republican and Democratic leaders of the panel, however, credited Cuomo for acting to tighten controls andspending.
The governor projects growth in the program to $56 billion nextyear.
The report comes as continuing criticisms arise from current and past employees of the OMIG, run by Medicaid Inspector GeneralJames Cox. Cuomo officials disagree with the allegations of poor performance, a reduced effort to weed out fraud and penalize wrongdoers, and lowmorale.
Panel members voted to adopt the report after it was edited to emphasize Cuomo's attempts atreform.
Only New York Rep.Carolyn Maloney, a Democrat, refused to accept the report, saying it lacked balance and insufficiently praised Cuomo'sefforts.
"This report focuses only on one state as if it were the only state where there is a problem," shesaid.
ChairmanDarrell Issa, R-Calif., said he agrees that Cuomo is taking positive steps. But he and others on the committee emphasized that New York was an obvious target for reform recommendations because it has been an extraordinarily big recipient of Medicaid funds, topping twice the per capital average inspending.
The committee's report, titled "Billions of Federal Tax Dollars Misspent on New York's Medicaid Program," calls for the state to crack down on wealthy imposters posing as indigent patients and on excessive salaries paid to health careadministrators.
"It is clear to the committee that there is more that New York and the federal government can do to make the state's Medicaid program more cost-effective," the report emphasized. Committee officials said either the federal Centers for Medicare and Medicaid Services or the Government Accounting Officemust send auditors to New York to examine OMIG and Medicaid programs. A committee spokesperson said the panel will follow up to push for an auditpromptly.
The committee noted OMIG has been the subject of stories in New York media, including the Times Union, that suggested it has become a dysfunctionalagency.
A Cuomo spokesman had no comment Thursday, but referred a reporter to remarks of Rep.Elijah Cummings, D-Maryland. Cummings said he voted to support the report because the final draft properly acknowledged Cuomo's efforts to restructure Medicaid in NewYork.
The state Legislature, he added, needs to go along with the governor's push to eliminate practices used by affluent couples to avoid long-term care costs, and to codify the governor's program to cap executive pay for organizations primarily funded with taxpayerfunds.