Rockland County Fights Medicaid Fraud

PRESS RELEASE–  Rockland County has saved nearly $7 million in Medicaid expenses by rooting out fraud, County Executive Ed Day has announced.

“Medicaid costs make up 55 percent of our county budget,” the County Executive said. “We owe it to the taxpayers to do all we can to make sure this program is being used appropriately.”

The County Executive has also announced that he is continuing to work to stop the state from charging counties for Medicaid.

“We have to pay these astronomical costs, but we have no say in how the program is run,” he said.

New York is the only state in the nation that requires counties to pay for Medicaid.

Day lobbied the County Executives of America, an influential non-partisan advocacy group of which he is a board member, to pass a resolution calling for New York to change its policy of requiring counties to pay for Medicaid

The organization passed a resolution calling on the state to change its policy. The resolution had bipartisan support, with the county executives of Orange County and Albany County co-sponsoring the resolution.

“We will continue to fight to get this expensive mandate off our backs,” Day said.

In 2016, Rockland County spent $66 million on Medicaid. There are 107,000 people in Rockland County who receive Medicaid benefits.

During Day’s three years in office, the county has focused on Medicaid fraud on two fronts.

“We are appropriately aggressive,” the County Executive said.

The Rockland Department of Social Service’s Special Investigations unit has identified numerous cases of people receiving benefits when they were did not meet income eligibility guidelines.

That has saved $3.5 million, the County Executive said.

The county has also used a highly successful and cost efficient system of front end detection strategy to save $3.4 million in costs.

The goal of the front end detection strategy is to identify potential fraud or misuse at the time of application, before tax dollars are spent on benefits.

“Our investigators look for indicators that have been approved by the state as red flags, including expenses that exceed reported income, applicants who have worked off the books or people who are self-employed but don’t have records to substantiate reported information,” Day said.

Front end detection is key because it enables the county to avoid paying expensive benefits to an ineligible applicant instead of trying to recover funds later.

Rockland County works with other agencies to track down suspected fraud, including the New York State Office of the Medicaid Inspector General.

When fraud is found, the county refers cases to the Rockland County District Attorney’s Office.

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