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NY’s $124B Medicaid spending is BLATANTLY full of waste and fraud

Dr. Mehmet Oz, the federal Medicaid chief, is entirely right to probe New York’s bloated $124 billion spending on the program.

Cost controls and fraud prevention are anathema to the state’s political establishment and the leader of that establishment, Gov. Kathy Hochul, deserves the heat.

As well as the scrutiny of a House investigation into Medicaid fraud in 10 states, including New York and California.

New York’s gargantuan health program is far too fat not to be a prime target for scammers: The state provides free health coverage to well over a third of its population (the national average is closer to a fifth), and powerful special interests — unions as well as the hospital industry and “social service”-based political machines — scream at the mere suggestion that a dime of it is wasted or stolen.

Hochul will mention “bad actors in the Medicaid program,” but her actions to identify and prevent fraud are pretty murky.

In recent months, the Justice Department uncovered criminal fraud in the adult day care and personal care program (where Medicaid has seen explosive growth); in January, two Brooklyn fraudsters pleaded guilty to scamming $68 million in an adult-care fraud scheme.

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And Oz’s Centers for Medicare and Medicaid Services flagged a 121% jump in spending (possibly $196 million in fraud) on non-medical transportation services earlier this year.

“These cases expose ongoing program integrity vulnerabilities within the New York state Medicaid program and home and community-based service delivery system,” Oz notes.

The feds are ramping up enforcement via CMS’s Comprehensive Regulations to Uncover Suspicious Healthcare (CRUSH) initiative and the Justice Department’s new Division for National Fraud Enforcement.

Also under the microscope: Hochul’s decision to (supposedly) rein in soaring Medicaid payments under the Consumer Directed Personal Assistance Program by hiring outside contractor Public Partnerships LLC to manage payments to care workers.

Not only has that backfired by allowing monster union 1199 to enroll these workers and inevitably start lobbying for big pay hikes, the choice of PPL itself — after the other states quit working with the company for cause — is looking corrupt.

Solidly liberal, high-cost Massachusetts spends about $3,500 per capita on Medicaid; New York state, $6,200 — with no superior health results of any kind.

So the Empire State would spend $50 billion less if simply matched the Medicaid standards of “the people’s republic of Taxachusetts”: That’s an awful lot of money going for things other than covering the health-care needs of the poor.

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