Poloncarz, Szukala Release Findings Of 2016 Report From Office Of Erie County Medicaid Inspector General

Modified: November 23, 2016 9:14am

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Date: 
11/22/16

Today, Erie County Executive Mark C. Poloncarz and Erie County Medicaid Inspector General Michael R. Szukala reviewed the findings of a recent report issued by the Erie County Medicaid Inspector General’s Office (“MIG”) that analyzes selected Erie County Medicaid data for the period January 1, 2011 to October 30, 2016.

The report is the fourth in a series examining Medicaid usage in Erie County and reveals that the total number of county residents on Medicaid has risen due to the Affordable Care Act (“ACA”), with more than 31 percent of Erie County residents’ health insurance now being provided by Medicaid. If current trends continue, more than a third of Erie County residents will be on Medicaid by the year 2021.  Among other findings, the report also revealed that over one-third of Medicaid recipients are under the age of 21, that the number of enrollees continues to grow steadily at an average annual rate of more than 4 percent, and that in 2015 there are more Whites on Medicaid in Erie County than Blacks/African-Americans, Hispanics/Latinos and Asians/Pacific Islanders combined.

The full report can be read here: http://www2.erie.gov/medicaid/index.php?q=latest-news-0#node-4 

“The information contained in this report reveals continuing trends in Medicaid usage in Erie County and how the average recipient has changed since passage of the Affordable Care Act. We continue to see increases in the number of Medicaid recipients who are less than 21 years of age and in the number of white recipients, even while actual Medicaid costs to the county decrease as a result of the ACA’s reimbursement formula,” said Erie County Executive Mark C. Poloncarz. “The fact that the number of county residents who now receive their health insurance from Medicaid continues to rise reiterates the simple fact that poverty and the lack of affordable private health insurance for many working adults is a very real problem in Erie County. It is something my administration remains firmly committed to addressing.”

“Every year I prepare a report on Medicaid at the request of the county executive and each year I am surprised at what I find,” said Erie County Medicaid Inspector General Michael R. Szukala. “From this year’s report I learned that there are more Whites on Medicaid than Blacks, Asians, Hispanics and Native Americans combined, more than 40 percent of all Medicaid clients are children, and three of the fastest growing areas for Medicaid in Erie County are Hamburg, Cheektowaga and Tonawanda.”

Among its main findings, the report shows that for the first time since 2008, hydrocodone-acetaminophen is not the most prescribed Medicaid drug in Erie County. Hydrocodone-acetaminophen is one of many controlled substances in the opioid category. Considering how addictive that particular medication can be and how abuse has been well chronicled in recent years, such a drop is viewed as significant. Prescription ibuprofen and omeprazole – an acid reflux medication better known as Nexium – are now the number one and two most prescribed medications to Medicaid recipients.

“Hydrocodone is a controlled substance that was the most prescribed drug from 2008 through 2012,” Szukala noted. “Also known as Vicodin or Lortab, it is one of the most abused prescription drugs in the country. We believe the publicity surrounding the abuse of opioids combined with continuing physician and pharmacist education on opioid abuse, and the use of the I-STOP Program, have helped result in this positive development. The battle is far from over, but we believe this represents progress and shows our community is headed in the right direction.”

The report also notes that  of the total number of people on Medicaid in Erie County 12 percent were born in another country. This percentage includes immigrants who are now United States citizens. Pursuant to the rules of qualification for the program, most immigrants do not qualify for Medicaid until they have been in the country for 5 years or in a health-related emergency situation.

Among its other findings, the report also reveals that the percentage of clients on Medicaid in Erie County is approximately in the middle of all counties in New York State when comparing Medicaid clients to overall population. Comparing enrollment data as of September 21, 2016, a total of 26 counties in the state have a higher percentage of Medicaid clients than Erie County, 29 counties have a lower percentage, while six other counties have the same percentage of clients to population as Erie County.

Medicaid is a means-tested program, with acceptance into the program based heavily on an individuals’ monthly income. The reports from this year as well as 2014 indicate that the number of people on Medicaid has been steadily growing at an average rate of more than 4 percent per year, a trend that is expected to continue to rise.

“Our Medicaid data shows that many newly enrolled recipients are employed but now qualify for Medicaid because of the Medicaid expansion included in the Affordable Care Act. Repeal of the Affordable Care Act would immediately result in these individuals losing their healthcare coverage, which is not acceptable,” Poloncarz added. “We are a stronger community when we are a healthier community, and any attempt to repeal the Affordable Care Act will hurt the overall health and welfare of our County.”

The MIG team’s three employees are funded by New York State under a 2012 agreement. Since its inception in 2012, the Erie County Office of the Medicaid inspector General has completed or is in the process of completing 30 audits covering more than $89.7 million in Medicaid payments. This includes audits of transportation providers, pharmacies, assisted living program providers and durable medical equipment (“DME”) providers. The results of these audits have been submitted to the New York State Office of the Medicaid Inspector General for follow-up.

For more information:

On the Erie County Office of the Medicaid Inspector General, visit http://www2.erie.gov/medicaid/