Comptroller: DOH Paid Out $1.3B In Medicaid Premiums To People With Private Insurance

An audit released Wednesday by Comptroller Tom DiNapoli’s office found the Department of Health paid out $1.28 billion in Medicaid manage care premiums to people who already had private insurance.

The money, according to the report issued by DiNapoli’s office, was paid out over six years.

“Glitches in the state Department of Health’s payment system and other problems led to over a billion dollars in unnecessary spending,” DiNapoli said. “The department needs to improve its procedures and stop this waste of taxpayer money.”

The audit found $70.6 million in premiums were paid to managed care organizations that were realted to a third-party insurer. At the same time, Medicaid also paid out more than $591 million in inappropriate managed care premiums despite knowing of third-party enrollees’ coverage.

The audit recommended the Department of Health to bolster its monitoring efforts for inappropriate managed care premiums and implement controls that would remove those not enrolled through the New York State of Health.

New York’s Medicaid program is one of the costliest in the country, with 7.4 million enrolled and claims totaling $58 billion.

JCOPE Under Scrutiny After Hoyt Report


The top ethics and lobbying watchdog in Albany is coming under fire, with critics saying the commission needs to change in order to better investigate wrongdoing in state government.

“The real problem here is that JCOPE can’t be trusted,” said Zephyr Teachout, a Democratic candidate for attorney general, at a Capitol press conference on Monday. “When you can’t trust the watchdog body, then that actually hurts the public.”

The Joint Commission on Public Ethics, known as JCOPE for short, raised eyebrows Monday when it cleared former Assemblyman and ex-Cuomo administration official Sam Hoyt who is being sued for sexual harassment of violating the public officer’s law.

Hoyt was cleared in a report backed by Executive Director Seth Agata, a former Cuomo administration lawyer. Attorney General candidate Zephyr Teachout called for Agata’s resignation. The commission does not comment by law on specific findings “can only make findings public under limited circumstances, which often prevents JCOPE from being able to explain its actions; otherwise, the Commission’s work is confidential,” JCOPE said in a statement.

“We really need to make sure that JCOPE is constituted in a way that it can address sexual misconduct allegation and that’s going to require some structural changes,” Teachout said.

JCOPE’s top officials are appointed by the governor and the top legislative leaders in the Assembly and Senate. Reformers say that’s created problems with oversight.

“They weren’t designed to do a lot of the work they should be doing,” said Sen. Liz Krueger. “They need to be an independent entity accountable to no one in power.”

One proposal would appoint judges to a new watchdog entity that could exercise independence from the legislative and executive branches.

“The Joint Commission on Public Ethics was created as part of a political deal,” said New York Public Interest Research Group Legislative Director Blair Horner. “It’s a political creature. In many ways it’s answerable to those who appoint it.”

Albany will also be watching for the outcome of a reported investigation into the sexual harassment allegation leveled against Senator Jeff Klein, who had called for the investigation and denies the claim made by a former staffer. Klein himself called for the investigation.

“This has been a failed experiment now that’s gone on for decades,” Horner said. “The commission since it’s directly appointed by the people it regulates, it has an inherent conflict of interest, an inherent flaw.”

IVF Coverage Bill Pushed In Final Session Days

From the Morning Memo:

A coalition of groups that back a measure for reforming insurance coverage of in-vitro fertilization and fertility preservation treatments will release a report Monday that found the bill would cost New Yorkers 55 cents a month, a less expensive option than the current system of having some patients pay out of pocket.

The report comes as the Coalition to Help Families Struggling with Infertility is making an end-of-session push for the bill in the final days of the legislative session, due to conclude on June 20.

The bill would require insurance companies to provide coverage for IVF and fertility preservation treatments. The bill was approved by the Democratic-led Assembly earlier this year and is pending before the state Senate, narrowly controlled by Republicans.

“This report shows that the monthly cost of The Fair Access to Fertility Treatment Act is 55 cents. That means that instead of tens of thousands of dollars in out-of-pocket costs,life-changing treatments like in-vitro fertilization will cost policyholders less than an ice cream cone at McDonald’s, a song on iTunes or a bag of Doritos,” said President and CEO of RESOLVE: The National Infertility Association Barbara Collura.

“It’s time for the Senate to follow the Assembly’s lead so that New York can join neighboring states like Massachusetts, New Jersey and Connecticut in providing cost-effective, family-building options for its residents.”

The bill in the Senate is backed by both Republicans and Democrats, with the lead sponsoring being GOP Sen. Elaine Phillips. It’s possible, also, that inaction over the legislation could turn into a political issue in the upcoming elections this fall if the Senate doesn’t move on it.

Chfsi Report by Nick Reisman on Scribd

How Would A Gov. Nixon Deal With The Legislature?

The New York state Legislature is notorious and perhaps famous for its gridlock and dysfunction that can seem obtuse and confusing to outsiders.

And those governors, like Eliot Spitzer, who have tried to take an aggressive approach with the Legislature have been stymied when it came to their agenda.

Gov. Andrew Cuomo has been accused of strong arm tactics himself with state lawmakers, but the application of pressure has yielded results: Same-sex marriage, a limit on local property tax increases, increases in the state’s minimum wage, a paid family leave program and criminal justice reforms, among others.

He’s known when to use a stick, but he’s also been adept at deploying carrots when needed.

So how would Cynthia Nixon, an advocate for public education issues and an actress, handle Albany’s lawmakers as governor?

“I think personal relations are very important with people in politics and of course I would meet with people in groups and individually,” she said during a stop in Albany to speak with the Association of Small City School Districts.

But that’s also championing issues she says are important to voters, like mass transit and education.

“Our governor has not amplified the demands of voters and the needs of constituents,” she said. “I think education is certainly something that the vast majority of voters support and things like fixing the New York City subway. These are things that there’s a tremendous groundswell of demand for.”

However it’s not clear how as governor Nixon would have, say, lawmakers from boroughs outside of New York City and suburban swing counties embrace a congestion pricing plan or a tax increase on the rich.

“I think with the correct leadership out of Albany, I think we can pass a millionaires tax,” she said. “I think we should pass it.”

That would likelier be easier said than done, even if Democrats gain control of the state Senate, considering they would have to rely on votes from lawmakers elected from moderate seats in the Hudson Valley and Long Island to augment their majority.

The Daily News reported Monday at least five Democratic lawmakers in the Senate were opposed to a millionaires tax.

Nixon in part is relying on a Democratic majority in the state Senate, which the party hopes to achieve ahead of what is expected to be a wave year. Cuomo has worked well with Republicans in the Senate, though that relationship has soured, during his time in office. Liberal advocacy groups have taken issue with Cuomo’s bipartisan deal making, saying it has watered down progressive goals. Cuomo has touted this a way to get things done in a complex state.

“The fact of the matter is I’m not the only one up for election this fall,” she said. “I think once the Democrats decisively take back the Senate and with Andrea Stewart-Cousins in the leadership solidly we will be able to pass whatever revenue raising taxes that we need in order to fully fund our schools.”

Nixon Says She Would Keep Tax Cap, But Make It Easier To Break

Democratic gubernatorial candidate Cynthia Nixon on Monday in an interview on WCNY’s The Capitol Pressroom said she would keep the state’s cap on property tax increases in place, but would support making it easier for local governments and school districts to burst through if needed.

In March, Nixon called the spending cap “disastrous” and said it should be less onerous.

The tax cap, first approved in 2011, limits property tax levy increase to 2 percent or the rate of inflation, whichever is lower. A two-thirds majority of voters or a locally elected board can approved budgets that override the cap.

Still, since its inception, the cap has been seen has largely effective in stemming the growth of property taxes in New York, which typically are the highest in the country. The measure was a key victory for suburban communities outside of New York City especially, which pay high tax levies.

The cap is a signature economic achievement for Gov. Andrew Cuomo, who Nixon is challenging in a Democratic primary this September.

School districts and other local governments have fretted the cap and its link to inflation, which over the last decade have been under 2 percent.

Meanwhile, Nixon’s push for a millionaires to tax to partially fund mass transit improvements in New York City would likely face an upstream fight in the Legislature, even if Democrats gain a foothold in the Senate.

Nixon said there are other options for taxes, including ending the so-called carried interest loophole, which would need to be done in coordination with other states and is a measure Cuomo has said he supports.

“We have a lot of revenue raising options available to us,” she said.

Biz Council-Backed Survey Finds New Yorkers Skeptical Of Single-Payer

From the Morning Memo:

A poll to be released Monday backed by The Business Council found New Yorkers are leery of the creation of a single-payer universal health care system.

The poll, conducted by Mercury, found 54 percent of New Yorkers oppose the creation of a single-payer health insurance plan, with 33 percent who support it.

At the same time, 53 percent of New Yorkers polled reported being satisfied with the current health care system, compared with 41 percent who are not, the poll found.

A single-payer bill for now remains bottled up in the narrowly divided state Senate, where Democrats are pushing to gain control this November. In the Democratic-led Assembly, the single-payer push has been supported by longtime Assembly Health Committee Chairman Richard Gottfried.

A bill memo in support of the measure envisions the plan would be paid for with revenue actions proposed by the governor, plus federal aid,

“Numerous analyses document that a single-payer system would be most effective for reducing and controlling costs, for taxpayers, employers and individuals,” the bill memo states.

But the poll by the Business Council found concerns among New Yorkers the program would be too costly. Sixty-six percent reported that the tax burden would be too high, while 64 percent would be concerned with “Albany politicians in charge” and 60 percent would be worried about keeping their own doctor — a concern raised during the debate over the Affordable Care Act.

Still, the poll found 68 percent of New Yorkers would be supportive of expanding health care access for Medicare and Medicaid managed care and 63 percent would support expanded subsidies for middle-income families. Another 63 percent would also support changing insurance rules that would spur younger and healthier people to purchase coverage.

The survey of 600 likely voters was conducted from May 8 through May 11 and has a 4 percentage point margin of error.

Mercury Single Payer Memo by Nick Reisman on Scribd

Senate At Impasse With Lawmaker Out

For the last two days in the state Senate, meaningful activity has ground to a halt as lawmakers squabble over procedure, Democrats seek to force votes on reproductive rights and Republicans lob accusations of dysfunction.

The Senate has for the last 10 years been a focal point of the often topsy-turvy world of state government, a condition exacerbated by an election in which Democrats are trying to wrest control from the GOP conference, who hold a thin majority.

The issue stems from the absence of Sen. Tom Croci, a Republican from the eastern end of Long Island who is retiring at the end of the year and is currently on Navy reserve duty.

Croci’s absence gives Republicans 31 members in the Senate, one vote short of the 32 needed to pass anything in the 63-seat chamber. Democrats called attention to this on Thursday by uniformly voting against a bill that was meant to address concussions among high school athletes.

Republicans called the action “shameful” to vote against a relatively anodyne bill. Democrats, however, contended they were not alerted to the bill being considered since no active list — a schedule of legislation to be considered in the chamber on a given day — was made available for them.

“By throwing those procedures out of the window, that doesn’t serve anyone,” said Senate Minority Leader Andrea Stewart-Cousins.

Republican Senate Majority Leader John Flanagan saw it differently.

“You saw democracy in action and you saw Democrats playing games, shameless games, with children’s lives,” Flanagan told reporters after the session ended for the week. “The Democrats have decided they don’t want to govern. They want to have politics rule the day. It’s embarrassing, it’s disgusting.”

But Democrats at the same time have sought to force votes as well on issues like strengthening abortion rights in New York and providing greater access to contraceptives for women. Waiting in the wings for the last two days has been Lt. Gov. Kathy Hochul, whose constitutional power includes presiding over the Senate and, if necessary, casting a tie breaking vote.

For the time being, Hochul is yet to take the Senate president’s chair, which would allow her to rule an amendment proffered by Democrats to be germaine and attached to a bill for consideration.

“The governor and I are offended by the actions taken here today in the Senate,” Hochul said. “We believe it is vitally important for the opportunity to bring legislation forward in this house — legislation that simply says we would codify Roe v. Wade.”

A version of the Reproductive Health Act in a Senate committee later in the day was voted down, with Sen. Simcha Felder, a Democrat who provides vital support for Republicans keeping them in power, voting against it. Supporters maintain that if an up-or-down vote is held on the bill in the Senate it would receive support from several Republicans.

It’s unclear how much longer this will last, if at all. Lawmakers must still consider a host of mundane legislation that nevertheless remains vital for concluding the session, such as extending local sales taxes. The session is scheduled to end on June 20.

“We are here. We are putting things forward and we are expecting a vote up or down,” Stewart-Cousins said. “Quite honestly, we are trying to get the peoples’ business done.”

Also unclear is if Croci, said to be unhappy with the functioning of the Senate itself, will return.

“That remains an open question,” Flanagan said. “That’s a topic of discussion for Sen. Croci and the federal government.”

Meanwhile, there was a tell-tell sign that not much was planned for Thursday in the Senate: The hallway in front of the chamber, usually clogged with lobbyists seeking the ear of a lawmaker on a given issue, was relatively empty.

The Session Won’t Be Ending Early

Talk of lawmakers leaving town early in June was premature, as legislative leaders in the Assembly and Senate indicated they would stay through the scheduled end of the session on June 20.

“We’re here to work,” said Assembly Speaker Carl Heastie. “We’re scheduled to work through June 20. Unless some miraculous happens, we’ll stay here through June 20.”

Leaving early might not necessarily play well for lawmakers facing competitive re-election races this fall. Still, it’s tempting to see the Legislature want to wrap up early: There are no major deadlines approaching for sunsetting issues like mayor control of New York City schools or rent control.

At the same time, the Senate faces a more acute issue: At least one of their outgoing members, Republican Tom Croci, is not expected to return for the rest of the year, leaving an even narrower gap in the closely divided chamber between Democrats and GOP lawmakers.

But even if the end of the session is devoid of major concerns for now, there are still the matter of bills of local concern that lawmakers need to tackle for their home districts.

“It depends on what you mean by things getting done,” said Deputy Senate Majority Leader John DeFrancisco. “There’s a ton of local bills that may not have a lot of significance for people statewide, but matter a heck of a lot to people in their districts.”

With Girardi, MLB Discusses Sports Gambling In New York

Former Yankees Manager Joe Girardi was at the Capitol on Wednesday pitching lawmakers on regulations for sports gambling in New York – an idea that’s increasingly been embraced by most of the major sports leagues as a revenue raiser and as part of an effort to sustain fans.

“I think the law is coming, and it’s important for New York to be at the forefront that protects the integrity of the game,” Girardi said.

Legislation approved that authorizes casinos to allow sports gambling is already in place – added as lawmakers expected the U.S. Supreme Court to act on the issue. The court did just that earlier this month, striking down a federal ban on sports betting and leaving the issue up to individual states from a regulation standpoint.

Lawmakers are considering what sponsors have called a “comprehensive” bill on sports gambling that would allow it to be conducted not just in casinos and other gambling halls, but also on smartphone apps.

Sen. John Bonacic, the Republican sponsor of a bill in his chamber and chair of the Racing and Wagering Committee, said his measure was close to what is being backed by his Democratic counterpart in the Assembly, Gary Pretlow.

“I think we will pass the sporting bill that we put in with our two amendments,” he said. “His language is close to mine. I think we can come to an agreement.”

Assembly Democrats, meanwhile, have yet to discuss the bill in closed-door conference, but expect to do so.

Gambling has expanded in New York over the last decade, with commercial casinos being licensed in four regions of the state thanks to passage of a constitutional amendment. They sit alongside facilities that have for years been run by American Indian tribes.

“I’m not a big fan of gambling, but again, it’s legal here in the state and the members will decide,” said Assembly Speaker Carl Heastie. “But I’m not the biggest fan of gambling.”

Major League Baseball and the National Basketball Association have both embraced the push for sports gambling nationally, positioning their leagues to set up a system of taking bets.

But sports have had a weary relationship with gambling. Pete Rose was banned from baseball for betting on games, for example, and is barred from entering the sport’s Hall of Fame as a result.

“That’s something for the Hall of Fame to decide,” Girardi said. “I’m not on that committee; I don’t have a vote. Pete Rose was a great player, but the laws didn’t protect him doing what he did.”

Williams Urges Giants, Bills To Follow Jets Policy On Anthem

From the Morning Memo:

Candidate for lieutenant governor Jumaane Williams on Wednesday will release a letter urging the ownership of the New York Giants and Buffalo Bills to adopt the policy of New York Jets owner Christopher Johnson in vowing to pay fines incurred by players who do protest during the National Anthem before a game.

“New York prides itself as being a progressive state that embraces activism and free speech, but staying silent on measures like these tarnish that reputation and limit our ability to stand up for what’s right,” Williams wrote in the letter to Giants owner John Mara and Bills owner Terry Pegula.

“That is why I believe it is important that all three of New York’s NFL teams actively denounce this policy and support their player’s right to protest without fear of repercussion.”

Williams, a New York City councilman from Brooklyn, is challenging Lt. Gov. Kathy Hochul in a Democratic primary.

The National Football League announced last week it would require players and team personnel to appear on the sidelines during the anthem, but gave them the option of remaining in the locker room if they do not want to stand.

In the letter to the Giants and Bills, Williams wrote that he understands the public hazards of demonstrating and protesting.

“As an elected official running for Lt. Governor of New York, I am extremely concerned by the threatening environment divisive actions such as these have on communities across the state,” he said.

“After engaging in my own personal pledge protest, I received vitriolic hate mail, so I have been proud to stand with Colin Kaepernick, and all players who choose to take a knee.”

Giants Buffalo Bills Letter by Nick Reisman on Scribd