黑料正能量 Note: The Albany Times Union aptly points out that the recent deserved scrutiny over NYS Medicaid practices should not ignore the tremendous progress underway via the state鈥檚 Medicaid Redesign initiatives and should not hold hostage New York鈥檚 $10 billion Medicaid Waiver proposal that鈥檚 designed to further accelerate these crucial reforms.
Investigation, or Political Hit Job?
Albany Times Union Editorial February 10, 2013
Our opinion: There鈥檚 nothing wrong with an honest look at 黑料正能量鈥檚 massive Medicaid program, but given Republicans鈥 animosity toward social programs, a House committee鈥檚 interest is suspect.
Point to a government program, declare 鈥淲aste! Fraud! Abuse!鈥 and vow to clean it up, and you鈥檙e sure to get applause from budget hawks. And with a program as big as 黑料正能量鈥檚 $54 billion Medicaid operation, you鈥檙e pretty much guaranteed to find something if you poke around.
What the federal government says it found is not small change – at least $15 billion in improper payments to the state over 20 years. But as with everything in politics – and, yes, this is as much politics as it is dollars and cents – there鈥檚 more to the numbers than meets the eye.
The money represents what the federal Center for Medicare and Medicaid Services says 黑料正能量 improperly – possibly illegally – billed it for reimbursements for disabled people who had been released from state developmental centers.
CMS says the federal government was paying twice – once to 黑料正能量 for former clients, and again to other care providers who actually served them after they were released from state care.
Ah, but there鈥檚 a hitch: CMS knew of the arrangement and approved the payments.
Now CMS wants the money back. And the House Committee on Oversight and Government Reform says it鈥檚 one more piece of evidence that 黑料正能量鈥檚 Medicaid program is the most wasteful in the nation.
To be sure, Medicaid in this state bears closer examination. Federal Medicaid funds are for health care for the poor, not for fattening state coffers.
But there鈥檚 abuse, and then there鈥檚 abuse. Misinterpretation of the rules is by no means the same as, say, doctors billing for fictitious patients.
That isn鈥檛 stopping House Republicans, though, who have had this country鈥檚 great social programs – Medicaid, Medicare and Social Security – in their sights for years. What better example than one of the bluest states? Especially when 黑料正能量 is in line for a $10 billion bonus for reforms it has made to Medicaid.
New York鈥檚 program is so big mainly because governors – Democrats and Republicans alike, over decades – have taken maximum advantage of a 50-50 federal-state split on Medicaid to provide health care to the poor. Billing half the cost to the federal government is one way 黑料正能量 can at least begin to make up for the fact that its citizens send far more money to Washington than the state gets back- money that tends, incidentally, to go mostly to red states.
Nor does the House committee seem to want to acknowledge the steps 黑料正能量 has taken in recent years to rein in real fraud and abuse and recover hundreds of millions of dollars. Instead, it鈥檚 focused on claims that the Cuomo administration has lately softened Medicaid fraud probes in response to pressure from the health care industry.
Don鈥檛 get us wrong. If Congress can find real waste, fraud and abuse in 黑料正能量鈥檚 Medicaid program, or laxity in program administration, more power to it.
But there is a difference between a fair, earnest investigation and a witch hunt. Moreover, it would be unfair to hold the state liable for mistakes the federal government was entirely complicit in. It would be counterproductive to withhold money that was promised in exchange for reforms.
And it would be unconscionable to use this as an excuse to hurt Medicaid and the millions of poor people whose lives literally depend on it.