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Guest Column: State Sen. Tom O'Mara

"Medicaid still not a bargain for taxpayers"

ALBANY, Feb. 10 --The Legislature created the state Office of the Medicaid Inspector General, or OMIG, nearly a decade ago, in 2006. New York’s efforts in those days to root out waste in the state’s hugely expensive system of Medicaid sprawled across six state agencies and, to be straightforward about it, wasn’t very effective. OMIG was meant to bring oversight under one roof and make it stronger.

I was serving in the state Assembly at the time (before being elected to the Senate in 2010), including as the chairman of the Assembly Republican Task Force on Medicaid Waste, Fraud and Abuse where we examined ways to reduce the size of a Medicaid system that, back then, was costing state and local taxpayers roughly $45 billion annually. We looked at numerous cost efficiencies, but we also explored strategies involving cutting-edge technology that could pinpoint fraud, misspending, mismanagement and other waste.

When OMIG was first established, report after report showed that not only was New York State’s Medicaid system the most expensive in the nation, it was one of America’s most shockingly wasteful systems. Rip-offs, scams and other abuses were costing state and local taxpayers billions of dollars. The federal General Accounting Office (GAO), for example, estimated that 10 percent, $4.5 billion, of New York’s Medicaid spending was lost to fraud and other abuses.

So I read with great interest last week’s report that OMIG recouped $851 million in Medicaid spending in 2013 -- the largest amount ever. The Cuomo administration released this news the night before Medicaid Inspector General James Cox testified before the Legislature’s fiscal committees and touted the recoveries as showing that “New York is truly leading the nation in fighting fraud and protecting taxpayer dollars.”

My reaction’s twofold. First, it’s positive news anytime we reclaim taxpayer dollars.

My second response, though, harkens back to all those reports from a decade ago that kept making the point that at least 10 percent of our Medicaid spending was being lost to abuses and fraud. Ten years ago, Medicaid spending stood at around $42 billion a year. This fiscal year, the cost of Medicaid is projected to soar past the $60 billion mark. Sticking with a 10-percent mark for fraud and abuse savings, that could equal approximately $6 billion worth of savings within current Medicaid spending – which, of course, is a far cry from the $851 million in OMIG’s reported recoveries for 2013.

So while I fully acknowledge and appreciate OMIG’s ongoing efforts, the more critical point, I think, is that there’s a lot left to do before we proclaim that state and local taxpayers are adequately protected from wasteful Medicaid spending. The inspector general himself acknowledged that very point in his recent testimony (which you can read on www.omig.ny.gov, or watch online at www.nysenate.gov/hearings/2014).

Most of all, in my opinion, one common-sense question stands out: Can’t we do a better job of preventing Medicaid fraud before it happens, so that we don’t have to expend more valuable resources recovering it after the fact?

There’s a lot of positive work going on to reform Medicaid. The state’s Medicaid Redesign projects significant savings for the long term. The state is now picking up the cost of growth in local Medicaid spending. Local leaders, including Chemung County Executive Tom Santulli, continue groundbreaking efforts to reduce costs.

But we have to stay focused on the abuse and waste side of the equation. Huge amounts of upstate tax dollars go to support vast Medicaid spending statewide, especially in New York City, and we can’t keep footing the bill for Medicaid mismanagement. Just last year one report revealed that New York City’s Medicaid fraud detection program costs taxpayers $4 million more than it recovers in misspent funds.

During his recent testimony, Inspector Cox stressed the importance of a stronger state-local partnership to further prevent Medicaid abuses. I agree. Legislation I co-sponsor in the Senate would increase the reimbursement and enhance the incentive for counties undertaking successful Medicaid fraud prosecutions.

And I’ll end on another local note. OMIG’s latest report highlights the effectiveness of data-mining, fraud-prevention programs like one developed by the Horseheads-based Salient Management Company. Salient’s software, already successfully used by Chemung and nearly a dozen other counties statewide, as well as by the state OMIG to some extent, can keep pointing the way to potentially billions of dollars more in Medicaid savings – which is why I also sponsor legislation to reimburse counties for the cost of purchasing this technology and putting it to work in saving state and local taxpayer dollars.

For years I’ve been calling for the more widespread use of the Salient system. It’s a wise, cost-effective investment, and its utilization should be expanded.

Photo in text: State Senator Tom O'Mara

Schuyler County Officials

Legislature Members:

Top row (from left): Dennis Fagan, Jim Howell, Michael Lausell, Van Harp

Bottom row: Tom Gifford, Barbara Halpin, Phil Barnes, Stewart Field.

   
       

Legislature Chairman

Dennis Fagan, Tyrone 607-292-3687

Legislature Members:

Thomas M. Gifford, 535-9517

Van Harp

Jim Howell

Barbara Halpin, 594-3683

Michael Lausell

Phil Barnes, Watkins Glen, 481-0482

Stewart Field, Watkins Glen, 535-2335

County Clerk: Linda Compton, 535-8133

Sheriff: William Yessman, 535-8222

Undersheriff: Breck Spaulding, 535-8222

County Treasurer: Gary Whyman, 535-8181

District Attorney: Joseph Fazzary, 535-8383

 

State, Federal Officials for Schuyler County

Sen. Charles E. Schumer

United States Senate
313 Hart Senate Office Building
Washington, D.C. 20510-3201
DC Phone: 202-224-6542
DC Fax: 202-228-3027
Email Address: http://schumer.senate.gov/webform.html

Sen. Kirsten E. Gillibrand

United States Senate
478 Russell Senate Office Building
Washington, D.C. 20510
DC Phone: 202-224-4451
Website: http://gillibrand.senate.gov/

State Senator Tom O'Mara -- Chemung, Schuyler, Steuben, Yates, western Tompkins, Enfield, Ithaca (Town and City), Newfield, Ulysses(Trumansburg)

Room 812, Legislative Office Building
Albany, NY 12247
Phone: (518) 455-2091
Fax: (518) 426-6976
www.omara.nysenate.gov

Assemblyman Phil Palmesano-- Steuben, Schuyler, Yates
Room 723, Legislative Office Building
Albany, NY 12248
Phone: (518) 455-5791
Website: http://assembly.state.ny.us/mem/Phillip-A-Palmesano

 

© The Odessa File 2011
Charles Haeffner
P.O. Box 365
Odessa, New York 14869

E-mail publisher@odessafile.com
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