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July 2013 Column - Investigating Medicaid fraud needs to be priority of county executive


OFFICE HIGHLIGHTS

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oneilj - Posted on 02 July 2013

Last week, the Erie County Legislature concluded its investigation into what has been referred to as “document-gate,” the improper disposal of sensitive documents from the Department of Social Services. After the county comptroller brought the issue to the public’s attention, DSS appropriately revised its practices and has implemented changes to ensure that all documents are handled and disposed of properly.

When the issue first came to the attention of the Legislature, my colleagues and I in the minority caucus called for an immediate investigation. Identity theft is a major concern in our country. The number of identity theft incidents has reached 9.9 million a year, according to the Federal Trade Commission. While it was disappointing to learn that residents’ personal identification was compromised in the past, I am pleased that the issue has been resolved following Legislature hearings. The people we serve deserve to have their information protected and should not have to worry about being put at risk because of something the county did or did not do.

There is a second aspect of this issue that is far more serious and could be quite costly. The comptroller received a whistleblower tip that county employees were directed to rubber stamp Medicaid recertification applications. If that is accurate, it would mean that county workers weren’t verifying that the application met the requirements and applicants continued to receive Medicaid benefits without proof of qualifications. If any resident received Medicaid benefits when they should not have been, the county could face penalties and unnecessary costs. It was after being denied access to Medicaid documents and records that the Comptroller’s Office found personal papers in an unsecure location, which prompted the investigation into Medicaid document handling by DSS. Now that the document disposal issue is resolved, I think the county needs to shift its focus to the rubber stamping matter. An open and transparent review must occur to understand how and why this happened and prevent future mistakes. If rubber stamping of Medicaid recertification applications has occurred, that is a tremendous disservice to the hardworking men and women who support the program through their taxes.

While there are many residents who rely on Medicaid benefits and meet the requirements, there is still a significant amount of fraud and abuse within the system. New York State has reported in the past that approximately 15 percent of the cost of Medicaid pays for fraudulent claims.

One important question to the county executive: Where is the county’s Medicaid Task Force on this issue, and what information can it provide? This group was implemented to uncover and stop fraud and abuse in Erie County. If that is the case, how could the rubber stamping practice occur in our county offices even after the task force was created?

It is my understanding that a report will be released soon from the Comptroller’s Office that will detail the alleged rubber stamping issue and upon receiving that report, I will ensure that all necessary changes have been implemented and that the county is in full compliance with Medicaid procedures.