Friday, June 4, 2010


UC Comptroller Calls For Changes to NYS Medicaid Law

By Paula Sirc (From the pages of the SHAWANGUNK JOURNAL 06.03.10)

KINGSTON – Ulster County Comptroller Elliott Auerbach believes the county should be allowed to audit Medicaid providers. Auerbach, the self-proclaimed "people's watch-dog," said his office has joined with other county comptrollers across the state in calling for a revision of the law that currently restricts their offices from conducting a full-scale audit of the program.

Auerbach said the NYS Department of Health's (DOH) directive does not grant local authorities the power "to conduct traditional audits, administer recovery of overpayments, or use provider sanctions."

Since the county receives Medicaid claims directly from local providers and is financially responsible for almost 25 percent of each claim, Auerbach believes it should play a larger role in the audit process.

New York's DOH grants comptrollers limited powers to audit. In 2008, some $1,300 of Ulster County's Department of Social Services (DSS) client monies had been reported stolen from its Medicaid spend-down program. In 2009, after taking office as Ulster County's first comptroller, Auerbach initiated an audit of the county program.

The Medicaid spend-down program allows certain people to qualify for Medicaid — even if their income is higher than allowed under the eligibility criteria — by paying a portion of money out of pocket each month to the department. The amount of money collected from those clients can range between $25 and $500 a month, Auerbach said.

The comptroller's audit revealed an additional loss of $3,424 in client monies, procedural lapses in cash management, and a lack of internal controls.

Until the law that prohibits his office from a full audit of the program is repealed, Auerbach said he will use his resources "to audit what I can, where I can."

The comptroller claims that Ulster County's DSS has made improvements in its accounting practices since the audit. "They've made some inroads, however, there still are some blind spots that we are not totally comfortable with and it truly has to do with internal controls," he said.

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Anonymous said...

Info on the realities of medicaid. It pays medical providers next to nothing as compared to private health insurance and medicare. Most medical providers will NOT accept patients with medicaid as a stand-alone insurance.

Anonymous said...

I thought you were friends with Mike? If you continue to sleep with dogs like Woerner,Zweben,Spada and Blaber, you WILL get fleas.

Remember your roots, did you know any of these people 3 years ago?

Anonymous said...

Medicaid providers should definitely be subjected to outside audit... because although fewer facilities and physicians, etc accept Medicaid, those that due have often been suspect [common street buzz] of ordering unnecessary tests, prescribing unnecessary medications, overprescribing medications, etc... Perhaps some of these folks make back their [perceived] "losses" via utilizing these type of measures - ripping off both thier clients, the taxpayers and the government?

BTW, don't forget about the Medicaid "spin-offs" (so to speak). Straight up Medicaid - back in the old days - seemed much more forthright than what is going on now.