Schuyler County Expands Efforts to Reduce Medicaid Fraud and Abuse
First Year Savings Estimated at $400,000
The Schuyler County Department of Social Services (DSS) has instituted a new program aimed
at reducing the high cost of Medicaid in New York State. Beginning in April of this year, DSS,
through a contract with The Bonadio Group has conducted audits of Medicaid applications to
verify eligibility and identify fraudulent behavior. According to DSS Commissioner JoAnn
Fratarcangelo, “While we recognize that Medicaid and Public Assistance are valuable programs
for individuals and families that are truly in need, we also can’t ignore the fact that in public
benefit programs there exists the potential for abuse.” Legislature Chairman Dennis Fagan
added, “Any attempt to fraudulently obtain benefits serves to undermine the intent of public
assistance as a safety net and has contributed to the huge escalation in costs to our taxpayers. As
fiscal stewards of public funds it is our obligation to ensure that only those who are truly in need
receive this aid.”
The Legislature recently received a report from Tim Ball, Project Manager for the Bonadio
Group outlining results of the first six months of this initiative. Ball provided the following
statistics to summarize their efforts to date:
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Out of 60 cases (51 Front End Medicaid, 9 fraud) referred by DSS staff for review, 20 were
deemed to have resulted in taxpayer cost avoidance.
These cases had 55 related applicants resulting in $198,000 in annualized savings.
Based on the first six months, the program is estimated to save the County approximately
$400,000 in costs through a 12 month period.
Included in the above figures is Fraud Cases; of the 9 fraud cases referred, 7 have been
completed, resulting in 3 cases immediately removed from assistance programs and referred for
criminal investigation. These cases have 13 related applicants, and their removal resulted in an
estimated savings of $94,123 over a 12 month period.
The report can be found in its entirety at www.schuylercounty.us .
According to Commissioner Fratarcangelo, the County intends to continue the contract with
Bonadio and has additionally reinstated a Fraud Investigator as part of the 2014 budget process.
Chairman Fagan in confirming the Legislature’s support stated “We want to send a loud message
that any attempt to fraudulently obtain public funds will not be tolerated.”
Eligibility Review Program Healthcare Edition
Schuyler County
Department of Social Services
Overall Update – September 30, 2013
 Overall Program
• We have reviewed a total of 60 cases since April
2013; 51 Front End Medicaid and 9 fraud cases
• 20 of the total cases completed have resulted in
taxpayer cost avoidance
• These cases had 55 related applicants, resulting in
an estimated $198,000 in annualized savings
• Based on the first 6 months, the program is estimated
to save the County approximately $400,000 in
program costs through a 12-month period
Status Update – September 30, 2013
 Front End Medicaid Cases
• 51 cases referred to Bonadio since April 2013
• 38 cases are complete / 13 are in process
• 16 cases or 42% of the completed cases have
resulted in taxpayer cost avoidance
• The cases that resulted in cost avoidance had 42
related applicants for medical assistance/family
health plus resulting in an estimated $304,089 in
annualized savings
Status Update – September 30, 2013
 Front End Medicaid Cases (continued)
• Financial resources were verified or immaterial
financial adjustments were made in 13 cases or 34%
of the completed cases
• An appointment was not warranted in 9 cases or 24%
of the completed cases
• There are currently 13 cases in process
Completed Case Update
As of September 30, 2013
Front End Medicaid Cases
24%
42%
34%
Cases Resulting in Cost Avoidance
Not Warranting an Appointment
Cases Not Resulting in Cost Avoidance
Fraud Status Update – September 30, 2013
 Fraud Cases
• 9 fraud cases referred to Bonadio since April 2013
• 7 cases are complete / 2 are in process
• Of the 7 completed cases, 3 cases resulted in the
immediate removal from assistance programs and
may result in further investigation
• These cases had 13 related applicants, and their
removal resulted in an estimated $94,123 in
annualized savings