NORWICH – Methods for reforming New York State’s $53 billion Medicaid program, the most expensive in the country, are currently being discussed within the state’s legislature and, locally, at the Chenango County Department of Social Services.
Governor Cuomo gave Medicaid reform prominence in his “State of the State” message, and went further to issue an executive order for a Medicaid Redesign Team tasked with finding ways to save money within the program.
State Senator James L. Seward, R-Oneonta, said some proposals discussed recently in the Senate Health Committee were focused on more efficient delivery of services, including opportunities for savings, reduction of current costs, medical malpractice reform and qualifications for Medicaid eligibility.
In addition, the Senator agreed with a call for additional mechanisms to help prevent Medicaid fraud.
“Providing county governments with the tools they need to aggressively combat abuse and block fraud before it occurs will save localities money up front and ensure deserving individuals and families receive the appropriate care,” he said.
The Chenango County Department of Social Services fraud unit is busy taking phone calls daily, and mostly anonymously, from people reporting abuse of Medicaid, food stamps and other assistance programs. One popular abuse of food stamps is when a recipient grocery shops for a friend or neighbor and then receives cash after using their food stamps to pay.
“That’s particularly difficult for us to catch,” said DSS Income Maintenance and Child Support Director Sue Curnalia.
The number of Medicaid fraud cases discovered in 2010 were not immediately available.
Provider-related, as opposed to recipient fraud, is not something that happens locally, said Curnalia.
“Maybe because we are such a rural district and have a lot of state oversight. There are procedures in place to red flag situations,” she said.
Chenango County DSS Commissioner Bette Osborne said any or all reform – whether it be just for the administration of Medicaid or a take-over of the entire program – will have local consequences.
Job losses and recipients’ frustration could result. Osborne said she is concerned that clients won’t receive the same level of personal assistance filling out the multi-page Medicaid applications, and that the county office could loose state and federal administration aid.
“Until simplification becomes a reality, and with less and less local interface, will the state contract out the process or use state staff? Will there be regional centers for clients to access?” she asks.
Coordinating services for clients who need other types of social services are an issue as well, the Commissioner said, with uncertainty about being able to afford staff. She wonders if the local share paid to the state every week goes away, and the state takes over the administration and control of Medicaid, or whether the county will still pay the local share regardless.
Though it would certainly unburden local taxpayers, Chenango County Board of Supervisors Chairman Richard B. Decker doesn’t think the state will takeover Medicaid completely.
“The cost of the administration is nothing,” he said. “It just takes the control away from locals while still making them pay. They have no idea what it’s like out here in the real world,’ he said.