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By Jim Kenyon
Monday, September 08, 2008 at 6:15 p.m.

Read more: Local, State, Health

ONONDAGA COUNTY -- At nearly 600-million dollars, Onondaga County's Medicaid budget accounts for about 40 percent of the county's property taxes. Since the county beefed up its Medicaid Fraud Unit two years ago with investigators and special computer software taxpayers have been saving millions of dollars by exposing such things as the recipient who claimed she visited the emergency room 108 times last year, or the man with 155 prescriptions.

Action News obtained a Medicaid fraud report compiled by the County Department of Social Services. Since the beginning of this year, investigators checked into 597 tips and uncovered 382 discrepancies resulting in case denials. They also denied 300 people who misrepresented their income, secured 185-thousand dollars in repayments for medicaid and exposed 150-thousand dollars in overpayments. Overall they uncovered 1-point-3 million dollars in potential fraud.

The County referred 26 cases, worth 210-thousand dollars in potential fraud to the District Attorney's Office. According to Chief Deputy District Attorney Rick Trunfio, "when it gets referred to us... the level of intent and fraud is so bad or they just haven't cooperated with the agency."

Truynfio says the D.A.'s Office has an assistant prosecutor who specifically handles medicaid fraud. That prosecutor may become even busier. Onondaga County Social Services Commissioner David Sutkowy revealed his investigators have uncovered a potentially widespread problem with unlicensed home health care providers who are padding their hours or not providing care to Medicaid patients. "The referrals we got were from the County Department of Long Term Care based on suspicions they had."

The Mahoney administration now wants to expand its efforts with new procedures and computer programs like voice recognition software to prevent Medicaid fraud from happening in the first place.

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8 Comments on this Story
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Hiding behind Anonymous

Posted by Randy Smith, Des Moines, Iowa - Wednesday, October 08, 2008 at 4:35 p.m.

Listen Anonymous, if you are that angry at the system, maybe you should take a step back and re-read Scott’s post. The article stated “They also denied 300 people who misrepresented their income, secured 185-thousand dollars in repayments for medicaid and exposed 150-thousand dollars in overpayments. Overall they uncovered 1-point-3 million dollars in potential fraud”.

So maybe you can explain which part of Scott comment isn’t correct! His comment was correct. There are thousands of non-deserving people sucking the system dry and your anger at one man who made a correct comment about the people who are depriving you of a better system was just petty.

Don't blame Scott Grimshaw and the millions of other individuals who got off their butts because corporate America could no longer manage itself and city and state governments weren't properly monitoring the thousands of fraudulent Medicaid claims resulting in higher taxes and higher insurance rates. Think about how your words sound. You make yourselves sound like the helpless hurt victims and Scott Grimshaw is the big bad boogieman.

If you don't like your situation, simply do what Scott did. Leave your job, mortgage your home and cut a few of your personal comfort expenses such as (your food budget, personal spending, clothing, vacations, dinners out, personal financial security) and start up your own business. Apparently you think that people like Scott Grimshaw are born with a turn-key business and special privileges up their butt.... news flash... they earn those privileges. And yes, they struggle during the process. Oh, and as one who has owned my own business, I can tell you without a doubt that it’s the other way around, you don’t know what it is to “bust your ass”. If you did, you would have already enjoyed the luxury of 80-90 hour workweeks without pay, taking a day off every 16 days and then having to deal with clueless bureaucrats that sound way too much like you do. Build a successful business then come back and tell us you know all things about busting ones butt.

Besides, no one, including Scott said you didn't deserve better! But the fact remains, he is absolutely right. How does a system allow for such abuse and then seem so surprised when this abuse is publicly aired? This countries healthcare system is being raped by undeserving people and then beaten to death by the attorneys who defend them. And yes, you pay for those attorneys as well.

On a personal note, I would assume that if your healthcare is that near and dear to your heart, you clearly wont be voting for Barack Obama. He made it very clear last night during the second Presidential Debate that he wouldn't raise taxes on businesses earning under $250 K because they are already having such trouble paying for employee healthcare benefits, My 8 year-old daughter can explain to you why businesses earning under $250,000 K a year don't need employee healthcare... because businesses earning under $250,000 K / year don't have employees. I’m the sole wage earner in my house and I’m paying $2,000.00 per month for healthcare for my wife and kids…. what are you complaining about?

So “Anonymous Anonymous”, instead of blaming it on people who own a 4 bedroom house, why don’t you put your name behind your comments and join the community in going after those politicians who allow such travesties. It’s nice to hide behind anonymity but it must make it exceptionally convenient when you have no idea what you’re talking about.

Dear Carrie C

Posted by Amy Moore, Central Square, NY - Monday, September 15, 2008 at 5:23 p.m.

Nor should you allow anyone to make you feel bad for doing what must be done. You have all my respect for standing up and doing something to ensure you will not remain in your current position. I had to do it too. I do not know "Scott" or anything about him I simply felt he could not possibly mean it how it sounded...but I have been wrong before. Therefore, my apology! You are doing the right thing and ensuring your children are taken care of medically as it is your responsibility, as a parent, it is not optional, so by what ever means necessary to keep the babies healthy is the only thing you need to worry about...not what any one thinks or says. You should be proud of yourself for having the courage to stand up and make a difference in your life instead of just sitting down a crying about it. We need more woman like you. As far as John McCain is concerned I pray he does not become our country's President. He has more flip flops that Ron Jon!

ARE U SERIOUS?????

Posted by carrie c, NY - Wednesday, September 10, 2008 at 10:17 a.m.

Listen... Scott made a comment about these people getting a "free ride". I am sure there are plenty of people whom sit at home on their lazy butts and do nothing but watch tv and live off the government, but do not put the people whom are working to change their lives and their childrens lives. Im sure you never had to worry about Christmas presents for your children have you? I am a single mom whom the father of my children has been gon and dissapeared for years now,I have no family so its been just me, and you have no ides how hard it really is, and to have some jerk who dosent know the whole truth to put people he does not even know into catagories of getting "free rides". Im not proud of not being able to continue my education before i started a family, but Ii am doing it now, and i will not let ANYONE make me feel bad about that.

Nope not a bit.

Posted by Anonymous Anonymous, Marcellus - Tuesday, September 09, 2008 at 3:40 p.m.

Sorry Amy, I have known Scott for a while. This is how he is. He communicated his point clearly. We all got it. The Man lives in a 4 br house with his family in a really nice neighborhood and as far as I can tell he has no idea what it is like to struggle. You can see his monetary contributions to the republican party if you google his name, as well as a bunch of other stuff showing that is he very much not struggling he never has. Everything wrong with this country and this state has to do with people just like him. They think they know everything about everything but they don't/won't get down off their cushy high horse to check out the real world for themselves. Well here is the real world Scott.... you have NO IDEA what it is like to really bust your ass.

May have miscommunicated his message a bit.

Posted by Amy Moore, Central Square, NY - Tuesday, September 09, 2008 at 1:46 p.m.

I know what "Scott" said may not have sounded good to those who are really doing the right thing and yet still struggling. I don't beleive that message was for you. When I put myself through school I received food stamps and medicaid until I got my education and then worked my way up the corporate ladder until I made it. But for those people who could do without yet defraud to receive it is killing the pockets of all of us. His point is that it is not fair for the rest of us to pay for the fraud that Medicaid itself allows to take place. Paying $3535.00 a year for property taxes for a single mom who gets no child support, no state or federal assistance because she makes just over what is considered allowable, is appaulling.

ARE U SERIOUS?????

Posted by carrie c, ny - Tuesday, September 09, 2008 at 1:10 p.m.

I too, am recieving medicaid. I am a single mother of 2 children and i bust my ass working 50 hours a week to support my family, and my job does not offer health insurence. So YES my 2 children and I recieve medicaid. How else were my children supposed to recieve the proper health care that they deserve?? Should they just not go to the doctors? or when they are sick and i dont have the $100 for the antibiotics, should they just suffer?? Oh so next you will be saying that recieving food stamps is bad too, so as i work a full time job, go to school to try and better my childrens lives, when i get home should there be no food on the table??? I was not born into a rich family, and yes i had a baby right out of high school so i was delayed on getting a start in my own life. before you open your mouth and put people down about needing help from the government WHOM I ALSO PAY TAXES TO maybe you should try and think of other people besides yourself and what a pity party we should have for you because you own your own business and dont qualify for any type of medical assistance.

Thanks Scott

Posted by anonymous anonymous , Marcellus - Tuesday, September 09, 2008 at 6:44 a.m.

I live next door to you. I bust my butt at my job too. But my job does not offer Health Insurance to employees unless they are full time. And though I clock almost full time I am not a director or supervisor so they don't consider me full time so that they don't have to offer me insurance. Who do I work for? The same people who charge you up the wazoo for Property tax. Yup Skaneateles. So please don't make me feel like crap because you bust your butt and I get what you think is a free ride. I am busting my butt too and FREE anything is the last thing I am getting.

Medicaid Fraud

Posted by Scott Grimshaw, Marcellus - Monday, September 08, 2008 at 9:06 p.m.

You gotta love this Medicaid deal people are getting. I have to bust my butt as a small business owner to pay for my health plan while others in this county get a free ride. And to top it off, my property taxes are amongst the highest in the nation, part of which goes to pay for this Medicaid free ride. The other part goes to pay for a school system that doesn't educate.

And you wonder why upstate is dying? Way to go local state legislators. I look forward to the day when Johnnie D , Joan C and Bill Magnarelli are flushed from the political system.

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