LOCAL AUDITS FOR MEDICAID MILLIONS

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Until the law that prohibits his office from a full audit of the program is repealed, Auerbach said he will use his resources "to audit what I can, where I can."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

The First 500 Days of the Office of Ulster County Comptroller

KINGSTON, NY (June 1, 2010)… January 1, 2009 not only ushered in a new form of government in Ulster County, it also marked the beginning of Comptroller Elliott Auerbach’s effort to create an independent agency of the people serving to protect the public’s interest.

“May 16^th marked the 500^th day of our new form of government here in Ulster County,” said the county’s first comptroller. It is a milestone for responsive and responsible government and we wanted to document the culture of change and use this indicator to look back, catalog our successes and track our thresholds” explained Auerbach.

“500 Days of Accountability” is a comprehensive report of initiatives and outcomes the Comptroller has compiled that signifies the efforts he and his staff have undertaken to discover and report on the economy, efficiency and effectiveness with which County government is run.

“We began our first few months authoring two reports on internal control practices within the County. That analysis identified several deficiencies, including a flawed financial management and reporting system. In addition, it brought to the surface the need to protect County staff with whistleblower protections, which the legislature subsequently acted upon” said Auerbach.

“We reviewed and improved the claims auditing function by which my staff serves as the last line of defense in assuring only valid, authorized claims are paid,” said Auerbach, “as a result I re-instated the use of claimant certifications to create an additional layer of accountability.”

The “500 Days” report lists a range of issued audits and reports from small cash counts to the massive review of the Ulster County Department of Health. “Our analysis of the Department of Health identified broad opportunities for improved processes and controls,” said Auerbach, “it also swept out from under the carpet the long-known need for control over nepotism – family hiring and working for family.” That report revealed how seriously dysfunctional government can become when a husband/wife team had unfettered control within the public domain.

“In this position it pays to remain dexterous,” said Auerbach, “like cautioning a legislative committee not to allocate funds of tens of thousands of dollars for a convicted killer’s medical bills without a full audit of the charges.”

As a result of creating a Comptroller’s Blog, Auerbach has had real-time communication with taxpayers. His fraud prevention workshop for not-for-profit organizations was well received and Auerbach said his Comptroller’s Advisory Committee has challenged him to ask new and different questions of County operations.

“Because we pull back the curtain to let the light shine on County government,” said Auerbach, “I established heightened ethics standards for my staff. It is our job to reveal the facts, not spin them.”

Elliott Auerbach is the first elected Comptroller in Ulster County. 500 Days of Accountability can be found on the Comptroller’s website at www.ulstercountyny.gov/resources/comptroller

Schenectady man defrauded Ulster County of welfare benefits, police say - The Daily Freeman Blotter: Serving the Hudson Valley since 1871(DailyFreeman.com)

Schenectady man defrauded Ulster County of welfare benefits, police say - The Daily Freeman Blotter: Serving the Hudson Valley since 1871(DailyFreeman.com)

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City of Kingston Overbilled $64k

May 17, 2010...The City of Kingston's SAFETY NET 2009 is currently being re-examined by auditors in my office and we are confirming that 91 of the over 4200 charges were inaccurate. While the percentage is small in comparison, the errors translate into an over $64,000 refund due to the City and being re-billed to several neighboring communities.

This process entailed nearly six weeks of information gathering and are intention is to now focus on 2008 charges.

DSS...ROOM FOR IMPROVEMENT

Ulster County DSS makes some improvements in its financial accountability, says Auerbach

KINGSTON – The Ulster County Department of Social Services has made some improvements in its accounting practice since County Comptroller Elliott Auerbach first looked into them earlier.

Missing funds reported to the County Sheriff’s Office before the comptroller’s office kicked in under the new charter, resulted in a comptroller’s audit of the Social Services Medicaid spend-down program in August 2009. Concerns regarding cash management and internal controls were found.

The follow up audit shows some improvement, Auerbach said.

“They have 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.

Noting that county comptrollers are prohibited in New York State from auditing Medicaid providers, Auerbach said until that is lifted, he will use his resources “to audit what I can where I can.”

(Copyright © 2010 Mid-Hudson News Network, a division of Statewide News Network, Inc.)

Ulster County has $18M fund balance, down from $24M | recordonline.com

Ulster County has $18M fund balance, down from $24M | recordonline.com

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A DELICATE $$BALANCE$$

Annual Ulster County financial report shows 2009 with balanced budget

KINGSTON – Ulster County used $5.7 million from its unreserved-unappropriated general fund balance to balance the 2009 county budget of $259 million.

The county remained within the five percent to 10 percent recommended percentage that the unreserved-unappropriated fund balance should be as part of the total general fund budget. The county’s balance was 6.5 percent.

County Executive Michael Hein said there is a positive message when analyzing the budget.

“In the face of a $7 million reduction in sales tax revenue, by making significant internal budgetary cuts and additional revenues, we created a situation where the taxpayer did not suffer and ultimately we are in better position going forward,” he said.

Hein said, though, that Ulster must still move forward with his 10 point Taxpayer First Initiative to begin closing the projected budget gap for fiscal year 2011.

(Copyright © 2009 Mid-Hudson News Network, a division of Statewide News Network, Inc.)