The Real Medicaid Fraud
by Edward A. Benoit
At 11am on Monday, July 30, New York State Senator Mark Grisanti held a press conference on the steps of the Rath County Office Building. The subject of the poorly attended event (the only attendees to speak of being myself and a lone reporter from the Buffalo News, compared to over half a dozen individuals from Grisanti’s campaign and local government) was Grisanti’s support of two related pieces of legislation that, according to Grisanti, absolutely must pass the New York State Assembly, as the very fiscal well-being of the state hangs in the balance.
By an astonishing coincidence, Grisanti is a co-sponsor of both pieces of legislation. Oh, and he’s in the middle of running for re-election.
The first of the two bills in question is nothing new, especially if you’ve ever happened to sit on the New York State Senate Standing Committee on Health. It’s Bill S. 4384D, which calls for the creation of a “Medicaid identification and anti-fraud biometric technology program,” according to an email/press release from the Grisanti campaign.
In a nutshell, the bill would require Medicaid providers to purchase biometric scanning hardware (i.e., machines capable of scanning one’s fingerprints or palm prints) and for New York to index this data for every person on Medicaid in the state. If the purchaser’s biometric data doesn’t match that on his or her Medicaid card, he or she can be denied service—the operative idea, according to Grisanti, is to stop fraud at the point of purchase rather than resorting to the “pay and chase” method of tracking down and stopping fraud.
On the surface it seems like a clear-cut, sound idea. The Grisanti campaign even provided some numbers, ostensibly to remove all doubt: An estimated 10 percent of New York State’s $54 billion allocated for Medicaid is spent on fraudulent claims. So it’s a good idea, right?
A further analysis of the relevant figures shows the matter is far from clear-cut. According to a piece in the Buffalo News regarding this very same press conference, only 10 percent of healthcare fraud in New York State is attributable to consumers—the $5.4 billion figure implied by the Grisanti campaign just got a lot smaller. The lion’s share of Medicair fraud is perpetrated by individual doctors, medical groups, hospitals, and clinics.
There’s also the matter of just how much it will cost to outfit every Medicaid office in the state with biometric technology. Expectedly, Grisanti was more than a little vague on this point.
“I would estimate, in talking with companies that actually have the capability…that each machine, my understanding is, at each location costs about $100,” said Grisanti. “But where you first start out is implementing the computer program…the cost of that system I don’t know off the top of my head, but each facility would have to roll in that cost to have it further.”
So, then, why would Grisanti support such a bill without being able to put together a comprehensive cost benefit analysis?
The answer to this question might be gleaned from the Grisanti-co-sponsored rider bill, S.7447, which seeks to reinstate the discontinued STAR rebate program with the hypothetical massive savings from Grisanti’s other pet piece of legislation.
So, let’s see here—we’ve got a promise of tax cuts, a promise of budget neutrality, and a promise of ending the fraudulent use of every Republican’s favorite whipping boy, “entitlement programs.” The more cynical among us might jump to the conclusion Grisanti is publically backing this half-baked scheme to pander to a disenchanted Republican base that’s still pissed about his support of marriage equality.
Well, the cynics would be right, because that’s exactly what he’s doing.
“If we’re able to do this,” said Grisanti, regarding S. 4384D, “we could then reinstate the middle class STAR rebate that was not renewed in the 2009 budget cycle by the downstate New York City Democrats.”
I’d lay off those downstate Democrats if I were you, Grisanti, since, last I checked, almost half your campaign contributions from July 2011 and January 2012 came from them.blog comments powered by Disqus
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