Hochul donor, Medicaid contractor value NY taxpayers as much as $195 million

Gov. Kathy Hochul is standing by a contractor — tied to greater than $100,000 in donations to her marketing campaign by her — that federal probers say botched the Medicaid transportation program in New York Metropolis, doubtlessly costing taxpayers as a lot as $195 million in paybacks to the US authorities.

The latest US Division of Well being and Human Providers inspector basic report ordered the state to reimburse the federal authorities for at the least $84.3 million in state Medicaid funds due to a scarcity of file preserving to justify billing for transport providers for Medicaid sufferers throughout the calendar years 2018 and 2019.

Medical Answering Providers was the chief contractor that served because the state Well being Division’s “transportation supervisor” to oversee and prepare transportation providers with suppliers — similar to taxi rides and ambulette providers — throughout the interval and its contract with the state for the Huge Apple area was prolonged by way of November 2023.

As The Submit beforehand reported, the agency’s proprietor, Russ Maxwell and his partner, Morgan McDole, have dropped greater than $300,000 mixed into the marketing campaign coffers of Hochul, of former Gov. Andrew Cuomo and the Hochul-controlled state Democratic Social gathering.

Russ Maxwell and his partner have contributed greater than $300,000 to Hochul’s marketing campaign.

The couple has additionally dumped greater than $100,000 mixed into the marketing campaign coffers of Hochul, as governor and earlier than that lieutenant governor underneath Cuomo — and the Hochul-controlled state Democratic Committee. They’ve dropped one other $236,000 into Cuomo’s coffers through the years.

The agency has been awarded greater than $400 million in state contracts since 2011.

The HHS IG additionally estimated that New York claimed a further $112,028,279 in federal Medicaid reimbursement from suppliers managed by Medical Answering Providers “that won’t have complied with sure Federal and State necessities” — and mentioned state officers ought to work with Medical Answering Providers to “refund to the federal authorities any unacceptable quantities.”

Requested if they’d cease doing enterprise with Medical Answering Providers, Hochul spokesman Avi Small mentioned, “The Government Chamber has no involvement within the company RFP course of and didn’t direct, counsel or suggest to the Division of Well being that they need to choose a selected vendor for this contract.”

The Hochul rep additionally famous the contract was initially awarded throughout a interval when Cuomo was governor, and she or he was lieutenant governor.

New York State Governor, Kathy Hochul
Medical Answering Providers was the chief contractor that served because the New York Well being Division’s “transportation supervisor” to oversee and prepare transportation providers with suppliers.
Getty Pictures for Concordia Summit

A state Well being spokesman mentioned Wednesday that “whereas the Division disagrees with lots of their findings” it “will work with HHS to handle all considerations as clearly acknowledged in our response.”

“We’re dedicated to making sure that Medicaid members can entry environment friendly transportation to obligatory medical providers and that transportation suppliers appropriately doc their providers,” mentioned spokesperson Cort Ruddy.

And in a June 8 response to the audit, Kristin Proud, the well being division’s appearing government director, defended the Hochul-tied firm, saying: “The brand new [transportation manager of Medical Answering Services] had established a file of offering prime quality, cost-efficient service in 55 of New York State’s 62 counties,” and outbid its rivals for the providers offered. She insisted that Medical Answering Providers saved the Medicaid Program “virtually $19 million per 12 months.”

Medical Answering Providers declined to remark for this text.

Hochul’s Republican opponent within the race for governor, Lengthy Island Rep. Lee Zeldin, mentioned the brutal federal audit involving a Hochul-connected contractor is extra purpose voters ought to select him to run the statehouse.

“Pay-to-play corruption is Kathy Hochul and Albany’s favourite pastime. Kathy Hochul enthusiastically trades entry and hard-earned tax {dollars} for marketing campaign donations,” Zeldin charged.

“The state wants to right away cancel contracts with this firm and Kathy Hochul should instantly return the large quantity of marketing campaign money she obtained from this authorities vendor.”

Michael Henry, the GOP candidate for legal professional basic within the Nov. 8 election, mentioned “this soiled deal must be stopped” and questioned the interactions of Hochul’s workplace with the agency’s lobbyists throughout the contract bidding, saying the matter “have to be totally investigated. ”

New York State Governor, Kathy Hochul
“Pay-to-play corruption is Kathy Hochul and Albany’s favourite pastime,” mentioned Lee Zeldin.
Getty Pictures for Concordia Summit

The pay to play allegations are simply the most recent to be leveled at Hochul, who’s going through requires a probe over $637 million in no-bid state contracts. to political donor Charlie Tebele’s Digital devices agency. Tebele hosted a marketing campaign fundraiser for Hochul final November — simply 4 days earlier than she declared a state of emergency that paved the best way for his firm to obtain the contracts. And he and his relations have funneled $300,000 to Hochul’s marketing campaign.

Medicaid is the federal public medical health insurance for the needy whose distribution is overseen by states. Federal guidelines require that states present obligatory transportation for Medicaid beneficiaries to get to and from medical appointments underneath the Non Emergency Medical Transportation Program [NEMT].

The federal authorities reimburses the state for a lot of the prices however “suppliers of providers should keep data obligatory” to justify the prices for the providers.

The audit lined 4,768,858 funds totaling $445 million, with $269.6 million billed to the federal authorities for which the state claimed reimbursement.

The audit sampled 100 funds and located solely 17 complied with each federal and state billing necessities, 41 didn’t comply and 42 others have been questionable.

The audit discovered 22 examples of offering “no legitimate medical practitioner’s order for transportation providers,” 13 examples of transportation providers that weren’t adequately documented, seven examples failing to offer proof of driver qualification necessities, and different snafus.

“The funds for unacceptable and doubtlessly unacceptable providers occurred as a result of the State company’s monitoring of its NEMT program and transportation supervisor was not enough to make sure compliance with necessities for authorizing, documenting and billing NEMT providers,” the audit mentioned.

“On the premise of our pattern outcomes, we estimated that the state company claimed at the least
$84,329,893 in federal Medicaid reimbursement for funds to NEMT suppliers that didn’t adjust to federal and state necessities. ‘

“As well as,” the audit mentioned, “we estimated that the state company claimed $112,028,279 in federal Medicaid reimbursement for funds to NEMT suppliers that won’t have complied with Federal and State necessities.”

The audit additionally mentioned the transportation suppliers “didn’t present any or didn’t present enough documentation” to find out compliance with driver and car necessities.

The audit mentioned the transportation supervisor — on this case Medical Answering Providers — is “accountable” to offer “prior authorization” to transportation suppliers to select up sufferers and for “sustaining documentation of the authorization.”


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