LTC Bullet:  Bipartisan Congressional Blast at New York Medicaid

Friday, February 22, 2013


LTC Comment:  Congressional Republicans and Democrats concurred in a scathing critique of New York State’s Medicaid program.  Details after the ***news.***

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*** ESTATE RECOVERY PROJECT:  The Maine Heritage Policy Center and the Maine Health Care Association have retained the Center for Long-Term Care Reform to conduct a study of Medicaid estate recoveries in Maine.  Our goal is to make recommendations that could double the state’s nontax revenues from this source while simultaneously encouraging Mainers to plan early for LTC and avoid dependency on Medicaid altogether.   We’ll begin the research for this project on April 1 and submit our report by May 15. ***



LTC Comment:  In its first bipartisan report in four years, the U.S. House Oversight and Government Reform Committee, led by Darrell Issa (R-CA), has lambasted New York state government for egregious abuses of Medicaid, including the welfare program’s most expensive long-term care component.

Following is the Committee’s press release announcing, describing and linking to the full report.  Further below, we provide links to some of the caustic newspaper articles and editorials the report engendered.  Finally, we offer some background on the Center for LTC Reform’s extensive work that identified and criticized many of the same abuses.

We especially applaud this report’s recommendations that New York Medicaid should enforce Medicaid eligibility rules, ban the “spousal refusal” gimmick used to dodge asset limits, and strengthen estate recoveries to discourage use of Medicaid as free inheritance insurance for heirs.


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

February 14, 2013

Contact: Ali Ahmad (202) 225-0037

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.” [This link takes you to a page with further links to a video and to the full published report.  If you watch the video, note that the committee’s deliberation begins at 7 minutes, 21 seconds into the video.] 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.  


Caitlin A. Carroll
Deputy Press Secretary
House Committee on Oversight and Government Reform
Chairman Darrell Issa
Rayburn 2157
Office: 202-225-0459
Cell: 202-579-7257


Media coverage of the Committee’s findings and report:

States fall for Medicaid trap,” by Betsy McCaughey, former Lieutenant Governor of New York, Boston Herald, 2/16/13

House panel: Medicaid is a $54B mess: New York's Medicaid system needs audit to study waste, abuse, draft report says,” by James M. Odato, Times Union, February 6, 2013. 

NY Medicaid exec pay is sickening,” by Carl Campanile and Chuck Bennett, New York Post, February 5, 2013

House panel adopts stinging report on NY Medicaid system,” by James M. Odato, Times Union, February 14, 2013


Over the years, the Center for Long-Term Care Reform has conduced several studies of Medicaid and long-term care financing in New York.  Examples of our reports that revealed and criticized many of the same conditions identified in the Oversight Committee’s report include.

NEW YORK: Our report: Long-Term Care Financing in New York: The Consequences of Denial, March 2011

NEW YORK: Long-Term Care Financing in New York: How to Save Money While Serving the Needy, shorter version of the above report published by the Empire Center (Link to abridged version of the report on the Empire Center website (pdf here))

NEW YORK: The New York Long-Term Care Compact Proposal: Update, Analysis and Recommendations, July 2007

LTC Bullet: Friendly Fire in the Class War (LTC Embed Report #6), Thursday, September 22, 2011:  This Bullet described Steve Moses testimony before the Oversight Committee on some of the same subjects as the Committee’s current report addressed.