FOR IMMEDIATE RELEASE
March 18, 2015
Contact: Scott Salotto (845) 638-5645

ROCKLAND COUNTY EXECUTIVE ED DAY CALLS FOR IMMEDIATE ACTION TO REDUCE FRAUD AND ABUSE OF MEDICAID SYSTEM

NEW CITY, NY -- Rockland County Executive Ed Day today called upon the County Legislature and local state representatives to immediately address the inherent shortcomings of Medicaid, which leave the federally-created, state-mandated program vulnerable to widespread fraud and abuse.

"Only by advocating together for critical changes to Medicaid will we successfully take steps forward in the battle to safeguard taxpayer resources and to ensure the integrity of essential health care programs," said County Executive Day.

County Executive Day wants New York State to:

• Require means testing/resource testing for all programs. (Long-term care applicants must "spend down." All applicants must utilize their own resources to some degree before accessing publically-funded assistance programs.)
• Increase in-person interaction with local DSS staff to confirm income and citizenship status. This includes comparison/coordination with other DSS programs.
• Ensure ALL online applications originate from an IP address within New York State.
• Develop term limits for Medicaid, ensuring that the program does not become a lifetime "right."
• Strengthen New York State fraud controls involving the Exchange.
• Hire additional County fraud inspectors with the ability to utilize revenues recovered for investigative purposes. (only in conjunction with necessary enhancements to existing Medicaid fraud safeguards, to ensure return on investment to County.)
• Push New York State to integrate improved technology to find other resources and share that technology with local Departments of Social Services to reduce fraud.
• Partner with the New York State Medicaid Inspector General (OMIG) to develop a process aimed at preventing fraud, as federal and state programs adopt an entirely "paperless" system.
• Create a united-front lobby to state and federal elected for common-sense changes.

In 2014, nearly 88,000 Rockland County residents - 27% of the county's total population - received Medicaid benefits administered by the county's Department of Social Services.

According to Rockland County Department of Social Services Commissioner Susan Sherwood, the majority of Medicaid funds reach those residents who need them and are qualified to receive them. However, a certain segment of recipients are not entitled to taxpayer-funded benefits and obtain them fraudulently. In addition, most providers of Medicaid services are honest in the pursuit of helping those in need, but some medical professionals do take advantage of the program.

"Our hardworking residents invest millions of dollars each year in public funds to assist their neighbors who need help – people who meet strict eligibility requirements to receive public assistance for the basic necessities of life," said the County Executive. "Dishonesty within our Medicaid system diverts precious taxpayer dollars, drives up the cost of health care and jeopardizes the strength of a program that serves our most vulnerable residents. The abuse of Medicaid prevents our neediest population from receiving help."

Even as the Department of Social Services and Office of Rockland County District Attorney Thomas Zugibe work in close partnership to identify and aggressively prosecute individuals and entities engaged in defrauding public assistance programs, Day believes more must be done to harden our Medicaid system. "Electronic enrollment, while efficient, leaves the system vulnerable to criminal activity," said Day. "Self-attestation during the enrollment process is a recipe for fraud."

"We need new tools to preserve Medicaid and protect our residents who rely on it each day," said County Executive Day. "Today, I call on the entire Legislature to formally push for meaningful reforms at the state and federal levels. Help me advance common-sense solutions to improve the access, quality, efficiency and value in our health care delivery system. We must protect a sacred trust and an earned guarantee."

Said the County Executive, "Fraud can inflict real harm on Medicaid beneficiaries. My Administration is committed to working with District Attorney Zugibe to get criminals behind bars and out of our public benefits programs as swiftly as possible. I will not stand idle and allow further 'gaming' of the Medicaid system on the backs of our county taxpayers," said Day.