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Suozzi: Medicaid flaw costly

Says state is losing $1M a year because its record system allows payments to HMOs for people who have died

BY SID CASSESE | Newsday Staff Writer

April 5, 2006

New York state Attorney General Eliot Spitzer is seen after a fundraiser at the Glen Oaks Country Club in Old Westbury. (Newsday / Karen Wiles Stabile / February 15, 2006)

Citing 47 people who died but were kept on as Medicaid recipients in Nassau, County Executive Thomas Suozzi called on the state yesterday to fix its flawed record-keeping system.

Suozzi, who is running against state Attorney General Eliot Spitzer for the Democratic nomination for governor, said at a news conference in Mineola that the state is losing at least $1 million a year in Medicaid payments to HMOs for dead people. He said state officials have known about the problem with its database since at least 2004.

"The state has failed to make Medicaid management a priority, despite it accounting for about 42 percent of its $110 billion budget," said Suozzi, pointing to a federal survey, released in 2004, that showed a possible $36 million in payments for dead people for the years 1998 through 2001.

Officials at the state Department of Health, which manages both the federal Medicaid program in New York and the state's Vital Records Office, would not respond directly to Suozzi's charges.

Rob Kenny, a department spokesman, said, however, that his agency checks the data at least once a year or upon the request of a county.

"But the county is responsible for checking the Medicaid enrollment status of those they serve," said Kenny. "We run matches on the county data to help validate their information. The county must then recheck all of the information. If we were to find a [health care] provider paying for service to a person already passed away, we would recoup the money and repay the county its share."

Suozzi, who has sought to make Medicaid problems a central campaign theme, said Nassau is seeking to recoup about $85,000 from five health management organizations that, through no fault of their own, received the payments for the deceased managed-care recipients in Nassau.