Winners Renews Call for More Medicaid Reform

George Winner

June 15, 2010

Albany, N.Y., June 15 – As talks continue between Governor David Paterson and state leaders to reach final agreement on the 2010-2011 state budget, State Senator George Winner (R-C-I) renewed his call today for this year’s state budget to immediately reinstate locally administered eligibility tests for Medicaid applicants and to begin to enact additional oversight mechanisms that many local and statewide officials believe can begin to provide billions of dollars in long-term cost savings in the state’s most expensive program.

“Medicaid costs a billion dollars a week in New York.  It’s the state’s single-largest expenditure.  It’s gobbling up taxpayer dollars and local resources in alarming and unsustainable ways.  But there’s not nearly enough attention being paid to getting this system under control.  Until we do, any talk about meaningful spending reform is hollow talk,” Winner said. 

Winner and his Senate Republican colleagues have not been silent this year on the need to combat abuse, fraud, and overutilization in New York’s $52-billion system of Medicaid.  Earlier this year, for example, the Senate Republican Task Force on Medicaid Fraud released a report and a series of recommendations for improving the state’s Medicaid oversight efforts.  Winner served as a member of the task force, which heard testimony from local leaders including Chemung County Executive Tom Santulli and Guy Amisano, chief executive officer of the Horseheads-based Salient Corporation, which has developed computer software proven effective at Medicaid oversight.

[See below for a copy of the task force report, "Combating Medicaid Fraud in New York State"] 
Winner said that the task force’s initial recommendations point to annual savings of up to $500 million and should be one of the cornerstones of this year’s final budget.

Despite the fact that they are on the front lines of implementing the Medicaid program, county officials have testified that the state inhibits their efforts to stop fraud at the local level.  They pointed to the 2009-10 state budget enacted by Paterson and the Democratic leaders of the Legislature last April as an example.  Last year’s budget eliminated the eligibility requirements for face-to-face interviews, finger-imaging and asset tests for applicants for Medicaid that are conducted by counties.  The interviews were intended to ensure accountability in the system.

Winner called for the immediate reinstatement of the asset-and-resource test for Medicaid eligibility determinations and to include the local Department of Social Services Fraud Unit as part of the application process.  Other recommendations being pushed by Winner will empower localities to boost their own fraud-detection efforts, and more aggressively target waste and overutilization of services by:

-- authorizing the referral of all fraud cases to local district attorneys in order to reduce the timeframe for prosecuting cases while permitting counties to keep a portion of all fraud recoveries;

-- allowing counties to access the State Medicaid Data warehouse to improve local efforts to uncover billing patterns that point to possible fraud or overutilization of services; and

-- creating an automated system to alert county officials when residents become incarcerated and, consequently, ineligible for Medicaid benefits.