Guest Column: State Sen. Tom O'Mara

“The right tools for the job”

ALBANY, May 2 -- It was just last year that a report from the U.S. Department of Health and Human Services ranked New York 26th in the nation in Medicaid fraud recovery. According to the report, states such as Missouri and North Carolina recover about three times as much in Medicaid fraud, while six other states recover twice as much as New York.

That’s not good enough. Not at a time when Medicaid is costing state taxpayers more than a billion dollars a week. And not as long as we have estimates that as much as 10 percent of the spending is lost to fraud and other abuses. In other words, in New York, that means as much as $5 billion misspent, wasted, or worse, ripped off. That’s simply unacceptable to the responsible patients for whom the system was intended, the honest providers doing their best to make it work, and, of course, the taxpayers.

Under Governor Cuomo’s leadership, the recently enacted state budget set in motion the most dramatic and, hopefully, the most successful overhaul of Medicaid since it was created nearly a half century ago. The bottom-line goal is to make the system less expensive because at its current rate of growth, it’s simply unsustainable for state and local taxpayers. It’s gobbling up local budgets.

While some effective avenues of preventing abuse, combating fraud, and rooting out waste have been and continue to be undertaken through the state Office of the Medicaid Inspector General created by the Legislature several years ago, the state attorney general, and others, the fact is that we still read too many news reports and state comptroller’s audits about ongoing abuses. So the questions stand: Can we do more to prevent the waste? Can we do it better? I think so. I’m currently sponsoring legislation in the Senate, for example, that calls for reimbursing local governments for the cost of purchasing modern technology that’s proven to help pinpoint cases of Medicaid fraud, as well as other potential abuses and inefficiencies within the system.

Any builder, electrician or mechanic worth his or her salt will tell you that a successful job starts with the right tools. The same holds true for the job of reining in the cost of Medicaid. One of the best tools in the box is cutting-edge, data mining computer software like that developed and continually fine-tuned by the Horseheads-based Salient Corporation. It can be key to building the foundation of an overall more cost-effective, efficient, better managed system of Medicaid.

For counties willing to make the start-up investment and then follow where it leads, we know it works. It reveals where and how to address the system’s shortcomings, including the primary culprits of overutilization, mismanagement, and outright fraud and other abuses. We know because it’s being used by a dozen of New York’s 62 counties, including Chemung, as well as the Medicaid inspector general. It was recently reported that Chemung County’s one-year-old Medicaid clinic, which utilizes this data tracking tool, has already produced significant savings.

But it starts with a county’s investment in the technology. A state reimbursement for this initial local cost could help encourage its more widespread use, which I believe would be a smart state expenditure likely to produce a vastly higher return to taxpayers in long-term cost savings. It at least deserves consideration. Just last week we saw a new USA Today analysis showing that New York has the nation’s most expensive Medicaid program. New York spends $2,903 per person, according to the report, while the national average is $1,364.

The governor has set the state’s sights on the need to control Medicaid spending as the number one way to address New York’s highest-in-the-nation tax burden. This year’s state budget took important steps, but we need to keep going. We need to keep at it. We need a "zero tolerance" policy to reclaim the millions, if not billions of taxpayer dollars lost to Medicaid abuse, fraud, and misuse.

Photo in text: State Senator Tom O'Mara

Schuyler County Officials

Legislature Members:

Top row (from left): Dennis Fagan, Thomas Gifford, Doris Karius, Glenn Larison

Bottom row: Michael A. Yuhasz, Barbara Halpin, Phil Barnes, Stewart Field

Legislature Chairman

Dennis Fagan, Tyrone 607-292-3687

Legislature Members:

Michael A. Yuhasz, 535-4967

Doris L. Karius, 546-5544

Barbara Halpin, 594-3683

Glenn R. Larison, 594-3385

Thomas M. Gifford, 535-9517

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: Margaret Starbuck, 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 Christopher Friend -- Chemung, Schuyler, Tioga
Room 720, Legislative Office Building
Albany, NY 12248
Phone: (518) 455-4538
Website: http://assembly.state.ny.us/mem/?ad=137