Advocates Call for Tighter New York Medicaid Rule Enforcement

September 27, 2011
By Ettinger Law Firm on September 27, 2011 9:42 AM |

Last week state legislators proposed New York Medicaid changes which would eliminate the financial involvement of local county governments--a state take-over of the program. However, this change would do nothing to curb the overall costs of the program. Lawmakers explain that reigning in Medicaid costs remains a top priority, and so additional alterations to the program are likely. Many observers are calling for tighter enforcement rules to root out fraud. Stricter enforcement of the program will likely target medical care providers who seek to collect money, but these changes may also affect individual residents who are working through the New York Medicaid application process.

An editorial in last Friday's Albany Times Union called upon the legislature not to go "soft" on Medicaid users. Recent problems of fraud in institutions serving those with developmental disabilities were used to highlight the current problem with the program. Some observers believe that homes for those who are unable to live independently because of age or disability are the site of the clearest patterns of excessive Medicaid utilization. Several years ago the New York Commission on Quality of Care and Advocacy for the Mentally Disabled noted that Medicaid billing for these services were "costly, fragmented, sometimes unnecessary, and often appeared to be revenue-driven, rather than based on medical necessity."

Senior care advocates believe that many disabled seniors find themselves in need of dental care, hearing aids, and similar basic services only to be shuffled to alternative medical appointments not of their choosing or tailored to their need. These advocates claim that Medicaid changes are necessary to correct the disconnect between needed services and the ones actually provided. On top of the programmatic problems, the state's Long Term Care Coalition noted that the Health Department lacks the resources to oversee these adult homes properly. The state body struggles to ensure that nursing homes and senior living facilities are abiding by state rules and regulations. The quality of elder care suffers as a result.

Together these issues suggest that far too many local seniors fail to receive the care that they need. To ensure that one's quality of life remains high in the golden years, local residents should take steps as early as possible to prepare for the help they might need. Our New York elder law attorneys work with community members on these issues, helping them apply for Medicaid, shield assets with a Medicaid Asset Protection Trust, chose appropriate long-term care insurance, and otherwise take steps to protect themselves if they need extra assistance.

See Our Related Blog Posts:

New York Lawmakers Discuss Possible Medicaid Changes

Medicaid Asset Protection Trust is Important Tool for New York Seniors