Oversight Committee Adopts Bipartisan Recommendations to Prevent New York Medicaid Misspending and Recover Past Overpayments

February 14, 2013

WASHINGTON – Today, the House Oversight and Government Reform Committee adopted the bipartisan Committee report entitled “Billions of Federal Tax Dollars Misspent on New York’s Medicaid Program.” The report details some of the historic problems with New York State's Medicaid program as revealed by independent investigators, news organizations, and the Committee's own research. The report shows that fraud, waste, abuse, and mismanagement has been a large problem in New York’s Medicaid program for decades. The report discusses the long-standing and aggressive State approach to maximize federal dollars flowing into the State through the federal Medicaid reimbursement.

The report makes several significant, bipartisan recommendations for reforming New York’s Medicaid program to save taxpayers billions of dollars a year.

Stop Overpayments and Recover an Appropriate Share of the Overpayments for Taxpayers

“CMS should finalize an agreement with New York on a corrected payment methodology that ends the developmental center overpayments as soon as possible. CMS should pursue recovery of an appropriate portion of previous overpayments in excess of reasonable costs for federal taxpayers.” – p. 28

Ensure Accurate Accounting in Correcting New York Medicaid Misspending 

“New York State has submitted several waiver applications to CMS that relate to the financing of its Medicaid program. The Medicaid Redesign Team (MRT) Waiver Amendment asks CMS to allow New York to keep $10 billion of the anticipated federal savings from the waiver… Before considering the merits of these waivers, CMS and the State must come to an agreement to reduce the State’s developmental centers to a rate of about one-fifth of their current levels, as CMS indicated was its intention at the September 20, 2012 hearing before the Subcommittee on Health Care, District of Columbia, Census and National Archives.” – p. 27

Complete an Independent Audit of New York’s Medicaid Program

“CMS or a qualified government watchdog agency should conduct a complete and independent audit of New York’s Medicaid program, including the work of New York State’s Office of the Medicaid Inspector General (OMIG).” – p. 28
Additional recommendations:

  • Only individuals who meet the legal eligibility thresholds should be enroll in New York's Personal Care Services Program.
  • New York should aggressively pursue estate recovery against those who abuse Medicaid eligibility rules.
  • New York's legislature should codify Governor Cuomo’s executive order that limits compensation of executives at organizations that are funded almost entirely by Medicaid.

The report discusses several steps taken by Governor Cuomo’s Administration to address the problems.  The report also discusses concerns that the Cuomo Administration has not been forthcoming with this Committee and the serious allegations that New York is not adequately policing fraud and abuse in the State’s Medicaid program.
The report was adopted by a voice vote. Only Rep. Carolyn Maloney (D-NY) voiced opposition to the Committee’s adoption of the report.