BROOKLYN MEDIA GROUP FEBRUARY 3 - FEBRUARY 9, 2017 13 MEDICAID “MILLS MUST BE CLOSED BK SNAP S THE VERRAZANO-NARROWS BRIDGE. Photo by Anthony Cozzolino Send us your photos of Brooklyn and you could see them online or in our paper. Submit them to us via Instagram, Twitter and Facebook by using the hashtag #HRPix; or email them to [email protected]. GUEST OPED There have been several attempts to reduce Medicaid costs over the past few years, but not all has worked out as planned. Some of these efforts have spawned unscrupulous Medicaid providers who are little more than “Medicaid pimps,” and what they are “pimping” are social adult day care programs. Adult day care programs are not a new idea. In the past, they were primarily a liated with nursing homes and geared towards people who had developmental issues or cognitive issues such as dementia. They provided structured activities and health supervision that helped their clients make the most of their abilities. Since the programs were associated with health care facilities, there was considerable oversight. But then these programs morphed into something new – social adult day care. And some of the providers who run them have fi gured out a way to exploit Medicaid. In 2011, Governor Cuomo’s Medicaid Redesign Team made recommendations for lowering costs. Funding to hospitals and nursing homes would be increased, but there would be caps on outpatient services and home care hours. Most importantly, instead of a fee per service arrangement, Medicaid recipients would receive services through managed care programs which would pay providers a fl at fee for each client. In theory, this was a good idea. Since managed care providers would only receive a set amount for each client, they would be less likely to provide more services than someone actually required. But providers now had the freedom to pick and choose their clients, and some quickly igured out a way to exploit the system: They would recruit people who needed the least amount of care. That way, they would have money le over and they could make a nice profi t. Some crooked managed care companies and social adult day care centers started to work hand in hand. The day care centers aggressively recruited people who were in good health and would require few services. Then they would be enticed to sign up for the a liated managed care plan with cash bonuses, casino trips, grocery vouchers and other perks. Although Medicaid regulations speciied that managed care clients had to need help with activities such as bathing, dressing and walking, stories started to circulate about social adult day care clients bounding up subway stairs or bicycling for blocks. So what’s being done to stop this? The NYS Medicaid Inspector General has a certifi cation process for social adult day care centers that have contracts with managed care providers. They will also investigate any complaints. But will this really happen? Some people believe that the state will be reluctant to fi nd fraud, because that will mean even less federal funding for New York’s Medicaid programming. And with a new administration in Washington, there may be even less money coming down the pipeline. Charles Ragusa is the Democratic district leader in the 47th A.D. THE HOT TOPIC BY CHARLES RAGUSA STORY: Verrazano tolls to go up; base subway fare remains fl at SUMMARY: The MTA board on Wednesday, January 25 voted to increase the tolls on the Verrazano Narrows Bridge, which would mean that, as of March 19, undiscounted tolls on the only connection between Brooklyn and Staten Island will rise from an already controversial price of $16 to $17. Our readers were quick to sound off about the fare hike, despite the MTA’s claims that toll increases today are the lowest they’ve been since 2009. REACH: 21,733 people (as of 1/26/17) FOR MORE NEWS, VISIT WWW.BROOKLYNREPORTER.COM
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