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Wednesday, July 20, 2005


TAX DOLLARS GO TO THE WRONG POCKETS: NEW YORK STATE'S $44.5 BILLION MEDICAID DISASTER 

New York State government agencies and bureaucrats have been inept when it comes to protecting the interests of taxpayers



The New York Times deserves a lot of credit for shedding light and informing the public about the scandalous way in which New York State's Medicaid program is administered. Calling the state's Medicaid program "a growing burden" the New York Times has shown in a series of articles how lax government oversight has allowed unscurpulous doctors, dentists and insurance scam artists to exploit the system. The revelations have highlighted the fact that New York is an expensive place to live because the state's citizens are forking over billions of dollars of taxes that go towards lining the pockets of criminals.

[NYT]: It has drawn dentists like Dr. Dolly Rosen, who within 12 months somehow built the state's biggest Medicaid dental practice out of a Brooklyn storefront, where she claimed to have performed as many as 991 procedures a day in 2003. After The New York Times discovered her extraordinary billings through a computer analysis and questioned the state about them, Dr. Rosen and two associates were indicted on charges of stealing more than $1 million from the program.

It has drawn van services, intended as medical transportation for patients who cannot walk unaided, that regularly picked up scores of people who walked quite easily when a reporter was watching nearby. In cooperation with medical offices that order these services, the ambulettes typically cost the taxpayers more than $50 a round trip, adding up to $200 million a year. In some cases, the rides that the state paid for may never have taken place.

School officials around the state have enrolled tens of thousands of low-income students in speech therapy without the required evaluation, garnering more than $1 billion in questionable Medicaid payments for their districts. One Buffalo school official sent 4,434 students into speech therapy in a single day without talking to them or reviewing their records, according to federal investigators.

Nursing home operators have received substantial salaries and profits from Medicaid payments, while keeping staffing levels below the national average. One operator took in $1.5 million in salary and profit in the same year he was fined for neglecting the home's residents.

Medicaid has even drawn several criminal rings that duped the program into paying for an expensive muscle-building drug intended for AIDS patients that was then diverted to bodybuilders, at a cost of tens of millions. A single doctor in Brooklyn prescribed $11.5 million worth of the drug, the vast majority of it after the state said it had tightened rules for covering the drug.

New York's Medicaid program, once a beacon of the Great Society era, has become so huge, so complex and so lightly policed that it is easily exploited. Though the program is a vital resource for 4.2 million poor people who rely on it for their health care, a yearlong investigation by The Times found that the program has been misspending billions of dollars annually because of fraud, waste and profiteering. A computer analysis of several million records obtained under the state Freedom of Information Law revealed numerous indications of fraud and abuse that the state had never looked into.

"It's like a honey pot," said John M. Meekins, a former senior Medicaid fraud prosecutor in Albany who said he grew increasingly disillusioned before he retired in 2003. "It truly is. That is what they use it for."


The maddening aspect of this investigation is the focus on how the government has done practically nothing to police and monitor the monstrous Medicaid program. The reason why these criminal elements have been able to exploit the system is because they know that the government doesn't care or is unable to adequately make sure that the right people are getting benefits for the right reason.

New York State pays out $44.5 billion in Medicaid benefits a year. Despite the fact that Medicaid payments have tripled since the late 1980's and that 400 million claims are paid out every year, "Health Department regulators uncovered just 37 cases of suspected fraud" last year.

New York's Republican governor, George Pataki, has belatedly attempted to fix the Medicaid problems after the first 2 articles in the New York Times were published, this week. While Pataki was pressing the flesh and trolling for votes in Iowa, the Times articles proved an embarrassment for Governor Pataki - not only back home in New York but around the country as well. If his presidential nominations are to be taken seriously (and they are not by The Galvin Opinion) he has a lot of catching up to do when it comes to reforming Medicaid. The New York Times said created "an independent inspector general's office and bringing in a former federal prosecutor to help reorganize the policing of the program"

You know that the state's Medicaid program is a total disaster when the New York Times, a notorious cheerleader for government largesse, is alarmed about the spiraling costs of a 40 year-old program that is a hallmark of the "Great Society." It's even more pathetic that a Republican governor has presided for 12 years over the Medicaid program that has grown into a grotesque unstoppable force and has done virtually nothing to protect the hardworking taxpayers of New York State.

1) New York Medicaid Fraud May Reach Into Billions - New York Times

2) As Medicaid Balloons, Watchdog Force Shrinks - New York Times

3) Governor Adds Muscle to Curb Medicaid Fraud - New York Times

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