Sen Addabbo: I Support Amending Public Health Law to Establish Medicaid Identification & Anti-Fraud Biometric Technology Program

Scanners to Be Used by Hospitals, Clinics, Pharmacies for Patient ID, Greatly Reducing Costs of Fraud

NYS Senator Joseph P. Addabbo, Jr. (D-Queens), a member of the Senate’s Committee on the Aging, supports a measure pending in the Legislature, A.6555/S.4384, which would amend the public health law to allow New York to rapidly roll out a fraud prevention technology program many legislators say is well overdue.

The proposal would implement a technology-based fraud prevention mechanism in hospitals, clinics and pharmacies all across New York by relying on biometric technology. Biometrics is the science and technology of measuring and analyzing biological data. In information technology, biometrics refers to technologies that measure and analyze human body characteristics, such as DNA, fingerprints, eye retina and irises, voice patterns, facial patterns and hand measurements, for authentication purposes.

The legislation will do away with the current and faulty practice of allowing each county to issue its own Medicaid card and strengthens weak identification requirements to access Medicaid services. The implementation of biometric technology in the Medicaid program will bring mass fraud to a halt due to the strong verification and authentication measures of the system. It will stop Medicaid payments for fraudulent services at the point of service rather than the “pay and chase” behavior New York has become too comfortable using.

The legislation would require the implementation of biometric palm readers and software in all hospitals, health clinics, and pharmacies. The technology would catch duplicate prescription requests and medical services. In addition to security, the driving force behind biometric verification has been convenience. Biometric devices, such as finger scanners, consist of: a reader or scanning device; software that converts the scanned information into digital form and compares matches; a smart card that stores the biometric data authentication, identification and payment authorization. The law would also require the NYS Department of Health to provide a report to the legislature on the cost and implementation of the Medicaid identification and anti-fraud biometric technology program within six months of enactment.

Explains Senator Addabbo, “Billions of dollars in Medicaid fraud are being wasted annually in New York State, and with anticipated further major cuts in Medicaid funding on the horizon, I am hopeful that this legislation could result in saving the state needed funds and protect health care for many individuals.” According to the Senator, the state will spend over $54 billion dollars this fiscal year (2011-2012) on Medicaid. Experts predict that 10%, or over $5 billion, comprises fraudulent charges to the state’s health insurance for the poor, disabled and elderly. It is Addabbo’s contention to cut out the fraud on such a tremendous scale first, before the state cuts billions of dollars in vital services for our children and the elderly infirm. “I believe that Medicaid’s skyrocketing expenditures are mostly caused by rampant fraud. It’s time our state legislature addresses this issue for our people and looks to prevent the annual theft of over $5 billion of taxpayer funds. Fraud prevention technology is the only practical mechanism to stop Medicaid fraud, abuse and overuse of services,” Addabbo concluded.

The $20 million one-time investment in the technology needed for this anti-fraud measure can be raised by implementing a one-penny-per-prescription charge for a six-month period on each of the $4 billion Medicaid-paid prescriptions written each year (on average, each Medicaid recipient fills 100 prescriptions per year and there are over four million Medicaid recipients in New York).

The legislation is now being reviewed by the state Senate’s Committee on Health before passage and being sent to the governor for his signature. If passed, the law will take effect immediately.

City Selects 50 Senior Centers to Close by David W. Chen - City Room Blog - NYTimes.com

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In Manhattan, the number is 16.

In Brooklyn, 11, and Queens, 10.

In the Bronx, it’s 9.

And for Staten Island, it’s 4.

Add the numbers up, and what you get is a borough-by-borough breakdown of the 50 senior centers that are slated to be closed on July 1 by the Bloomberg administration as a result of budget cuts.

The city’s commissioner for the Department of the Aging, Lilliam Barrios-Paoli, released the list on Monday during a briefing with members of the City Council. Someone who attended the briefing provided the list to The Times.

Mayor Michael R. Bloomberg formally announced that he planned to close 50 senior centers during his executive budget on Thursday. He said that the centers had to be closed because of a budget shortfall that he blamed on Albany’s inability to come up with extra money. Another 25 centers could be closed on July 1, too, if the city receives less money from Albany than it currently expects.

The administration picked the 50 centers largely on the basis of three criteria: the fewest meals served, the fewest hours open and the most maintenance or management problems.

The council member who stands to lose the most senior centers — seven — is Inez E. Dickens, who represents Harlem. And four are slated to close in the district of Melissa Mark-Viverito, who represents East Harlem and northern Manhattan. In all, 28 of the council’s 51 members have at least 1 senior center that is slated to close, though people who attended the briefing stressed that the final list is subject to change.

Cold Weather Is On the Way – and So Is Help with Heating Bills - Senator Addabbo Announces Home Heating Assistance Is Available...

Help is on the way for New York’s most vulnerable residents who are having trouble paying their heating bills this season. Hundreds of millions of dollars will be available through the Low Income Home Energy Assistance Program (LI- HEAP), according to State Senator Joseph P. Addabbo, Jr.

The Home Energy Assistance Program (HEAP) is a federally funded program that assists low-income households in meeting their immediate home energy needs. The Obama Administration is providing $359 million for home energy assistance to households across the state.

“The ability to heat your home can literally mean the difference between life and death. We will maintain our commitment to helping families in these difficult economic times, and assisting the most vulnerable among us,” said Senator Addabbo. “It is important that my constituents know this program is available and take full advantage of this help as soon as possible during the heating season.”

In New York, almost a third of HEAP households have a household member aged 60 or older. Funds are targeted to households with the lowest income that pay a high proportion of household income for home energy.

Households are eligible for benefits if total gross monthly income is at or below 60 percent of the state median income. Assistance is also available if the household is in an emergency situation - without heating fuel, running low on fuel or having heat-related utility service currently disconnected or scheduled for disconnection. Eligible homeowners whose primary heating system is inoperable and in need of repair or replacement can also qualify.

Addabbo adds, “Every year, applications become available in my office during the first week in November – I urge my constituents to take advantage of this program quickly now that the heating season has begun. Eligible apartment dwellers can receive $40 or $50; eligible households that pay for fuel can receive up to $700 depending on the type of fuel used. HEAP may help pay for: electricity, propane, natural gas, wood, oil, kerosene, coal or any other heating fuel. My staff will be available to assist those who need help completing the one-page color form. Applicants just mail back the completed forms themselves.”

Anyone who had applied for HEAP in past years will receive a new application in the mail. The new form is also available online from the NYC Department for the Aging at www.nyc.gov/aging in November or by calling the city’s Citizen Service Center at 311 and requesting a HEAP application.

The HEAP program is supervised in New York by the Office of Temporary and Disability Assistance and is administered at the local level by local departments of social services.

For more information, visit http://www.otda.state.ny.us/main/heap.

For more information about picking up an application or for assistance with filling out the form, call Senator Addabbo’s office at 718-738-1111.

Cash Crunch Leaves Senior Center Fighting for Life by BY Clare Trapasso - NY Daily News

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It seemed like a fairy tale ending to a hard-luck case.

A Woodhaven senior citizens center was in danger of closing while its funding was caught in limbo between two city entities.

So Serphin Maltese - the district's state senator at the time - stepped in. He presented the Forest Park Senior Citizens Center with a ceremonial check for $75,000 in October as he smiled for a photo that got widespread play in local weekly newspapers.

The dispute between the city Department for the Aging and the Queens Borough President's Office has been resolved.

But the center has yet to receive any of the approximately $250,000 in state and city money it was promised, including the $75,000 Maltese had so publicly pledged.

The center's longtime director, Donna Caltabiano, said she'll be forced to close within the next few weeks if the center doesn't get a quick cash infusion.

"I just can't believe that after 28 years, it's come down to 'We may have to close the doors to this place,'" she said.

To keep the place running, Caltabiano has borrowed nearly $30,000 - most of it from the 250 or so people who use the center, she said.

In addition, she hasn't cashed any of her paychecks since October.

"I don't know how I'm going to pay these people back," Caltabiano said.

The thought of losing the center terrifies folks like Gary Delancey, 60, a widower from Howard Beach.

He said he comes to the center at 89-02 91st St. three days a week for the dancing, bingo and companionship.

Many of the seniors there have become his second family.

The center is running out of time as it waits for the release of promised funds - including Maltese's emergency award.

"I don't know what's going on," Maltese, a Republican who failed to win reelection in November, told the Daily News.

The state Senate's finance committee assured him in October that the money would be awarded to the center, Maltese said.

Caltabiano said she fears what may happen to the seniors if the center closes.

"Some of them are going to die," Caltabiano said bluntly. "This place keeps them alive."

Pols Back Seniors in Fight to Save Centers by Ben Hogwood - Queens Chronicle

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In a corner of Jaqueline Eradiri’s office sits a 54-inch Sony Bravia flatscreen television, still in a box.

Seniors chat while waiting for lunch at Ridgewood Older Adult Center, in Ridgewood. The center hopes to win a contract with the city to remain in business next year.
(Photo by Ben Hogwood)

The TV will eventually be paired with a Nintendo Wii gaming system and brought out into the Ridgewood Older Adult Center, where seniors will have the opportunity to go virtual bowling, or play virtual tennis or even shoot virtual zombies.

But Eradiri, the executive director of the senior center, sees it all as a little ridiculous. Fewer than half of the seniors who attend the center know what a Wii is and she doesn’t expect it to get heavy use.

Still, she believes the facility needs the system — as well as the boxed Dell computer towers stacked almost to her office ceiling — just to have a shot at surviving the city’s reorganization of the senior services program.

The Department for the Aging is moving ahead with a plan that some estimate could shutter as many as 89 centers. The DFTA says the centers are underutilized, outdated and do not offer the services today’s seniors are looking for.

In fact, the agency claims that some 44 percent of the city’s 329 centers are chronically underutilized. An average of only 2 percent of the 1.3 million seniors in the city eat a meal at a center on any given day.

Now, the DFTA is preparing for the “longevity revolution.” By 2030, seniors will outnumber school-age children, accounting for one-fifth of the population. The city is in the process of awarding new contracts for the centers through a request for proposals process.

The DFTA wants centers to offer services that today’s seniors would be more interested in, such as walking clubs, blood pressure screenings, exercise classes, and other social activities and intellectual classes.

The RFP outlines the need for two different types of centers: senior hubs and neighborhood centers. The hubs each will have a maximum budget of $1 million and serve at least 200 meals a day and offer six daily health and wellness or art activities. The city will contract with between 15 and 25 of them.

Neighborhood centers will have a maximum budget of $500,000 and must serve 75 meals a day. They must offer three health and wellness and art activities daily. The city will contract with between 225 and 310 of them.

However, the plan is widely opposed, from seniors to center workers to politicians.

A Dec. 4 hearing on the topic brought a standing-room-only crowd to City Hall. Prior to the hearing, seniors marched petitions with 14,000 signatures from their peers to Mayor Michael Bloomberg denouncing the changes.

Bobbie Sachman, the director of public policy for the Council of Senior Centers and Services, was ecstatic about the participation from the elderly community. “It was a very empowering day for seniors,” Sachman said. “Given all the opposition ... we believe Mayor Bloomberg should withdraw this RFP.”

Borough President Helen Marshall has been a longtime detractor of the proposal. She gave testimony at the hearing, stating that moving forward with the RFP process would be “totally reckless and irresponsible,” especially during tough economic times, when centers will be heavily relied upon.

The plan, Marshall continued, would eliminate social adult day care programs, elder abuse prevention and many other support services. Also, it wouldn’t fund expenses for building renovations or major long-term equipment purchases, shifting the burden to the nonprofit group operating the centers.

William Thompson Jr., the city’s comptroller, has also attacked the funding plan for the overhaul.

Thompson stated last week that the math doesn’t add up. If centers apply for the maximum amount of money, as is expected, the city would not have enough to contract with more than 239 centers, 89 less than the current 329.

Also, more than $20 million of the $117 million for the contracts reportedly comes from allocations from the council or borough president’s offices, money that may not be available on a consistent basis.

Queens Councilmembers Joe Addabbo Jr. (D-Howard Beach) and Helen Sears (D-Jackson Heights) both issued statements protesting the proposal. “A society’s moral strength is judged in large part by how it treats its most vulnerable members, and in the case of our seniors, they are also some of our most valuable assets,” Sears said. “We must guarantee that any modernization will not result in a reduction of services.”

Eradiri said she plans to submit a proposal for the Ridgewood location to operate as a neighborhood center. To do so, she would need every penny of the $500,000, which is still less than her current budget. “But it keeps you open,” she said.

This is now the third RFP process the DFTA has gone through in the past year. The first was for case management, which helps older adults “age in place” by remaining in their communities.

The second was for the Home Delivered Meals Program, better known as meals on wheels. The city wanted to cut the number of providers from 98 to 20 in order to minimize cost and improve efficiency.

The Ridgewood center lost out on both contracts and as a result lost some funding for staff positions. Eradiri said the restructuring constantly has her spinning. With plans always changing, she finds herself unable to answer staff questions about what will happen in the near future.

“It makes you look so stupid,” she said. “It makes you feel so insignificant and stupid.”

Charles Weber, 80, comes often to the Ridgewood center and has done so since his wife died 17 years ago. He sits on the board of directors for the center and is fully away of the situation. He is a firm believer that the squeakiest wheel gets the grease.

“If we all squeak, maybe we’ll get some grease,” he said.

Queens Asks For An Extra $300 Million by Ben Hogwood - Queens Tribune

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Queens officials this month added their two cents to the proposed City budget and are asking for an additional $300 million-plus to be included to address the borough’s needs.

Borough President Helen Marshall and the Queens Borough Board have sent Mayor Michael Bloomberg a budget priorities package asking for additional funding to go toward a number of projects, including bolstering the borough’s police presence, maintaining six day library service and providing meal programs and homecare for senior citizens.

“The Borough Board urges you to ensure that the priorities contained herein be funded in the Executive Budget,” said Marshall in a letter to the mayor.

The City must approve a budget by July 1, the beginning of the 2008-09 fiscal year.

The mayor released his proposed $58.5 billion budget in January and, in February, the Borough Board held a public hearing where over 200 individuals provided input on the county’s needs. The board – comprised of Marshall, the county’s City Council delegate and the chairs of each community board in Queens – then determined which cuts could not be tolerated and forwarded its list of priorities to the mayor. While the board voted on the document, the City Council delegates abstained from voting as they will have to vote on the full budget, said Dan Andrews, spokesman for President Marshall.

“There were a lot of cuts, agency cuts, cuts to cultural institutions,” said Andrews of Mayor Bloomberg’s proposed budget. “Hopefully, they [the City] will make some of the restorations.”

One of the priorities in the document is fully funding the Queens Borough Public Library system so it can continue to keep its doors open six days a week. The system just started keeping a six-day schedule last year.

“We’re very appreciative that the Queens Borough President and the Borough Board care so deeply about libraries and recognize the value of the programs and services we provide,” said Jimmy Van Bramer, the director of government and community affairs for the system. “And of course, they recognize the incredible importance of having libraries open six days a week so working families, students and seniors can use the libraries on the weekends, when for so many people it is the only time they can use them.”

Van Bramer said the system would continue to work with the mayor’s office, the City Council and Council Speaker Christine Quinn to ensure the necessary funding is included in the budget.

The priorities package also renews the call for a police precinct in Flushing Meadows Corona Park. A report recently released by the advocacy group New Yorkers for Parks showed the 1,255-acre park had 99 reported felonies, from April 2006 to September 2007, more than any other in the City.

In addition, the borough board requested a new 116th Precinct to split the duties of the 105th Precinct, as well as new precinct houses for the 104, 108 and 110 precincts and additional officers in every precinct.

The proposed cuts to the Department of Housing Preservation and Development would have a substantial effect on groups that represent low-income tenants in housing court to prevent evictions and obtain repairs, said Cindy Katz, coordinator for community outreach and education with Queens Legal Services Corporation. The board requested these programs be fully funded.

“If the mayor is serious about decreasing the number of homeless and maintaining the affordable housing we have, cutting funds is not going to further his goal,” said Katz.

The board also requested $6 million be restored to the budget to ensure three child health clinics remain open.

“If a cut is going to eliminate a program, like the three clinics in Queens, we felt we had to work some way around that and keep those three clinics open,” Andrews said.

The board is also asking the City to restore $5.46 million to the Department of Aging for contract agency budgets, including senior centers, meal programs and healthcare.

The priorities package calls for money to be restored or increased in several other areas, including the Department of Youth and Community Development, the Department of Parks and Recreation, the Department of Small Business, the Department of Education, The City University of New York, The Department of Sanitation, the Office for Prevention of Domestic Violence, the Department of Cultural Affairs, the Office of the Queens Borough President, and the borough’s community boards.

To balance the additional expenses, the Borough Board proposed more than $800 million in revenue and saving options to offset the cost to fund the priorities package. Those proposals included an extension of the general business tax to insurance company business income, retaining the City’s share of the four percent sales tax on luxury items and consolidating the City’s procurement process.

“We hopefully will get a sympathetic ear from the City Council,” said Andrews. “We generally get some restorations. We are certainly hopeful that will happen again.”

Meals On Wheels Program On Brink Of Overhaul by Nicholas Briano - The Wave

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This Catholic Charities sponsored Senior Center at 90-01 Rockaway Beach Boulevard that prepares hot daily meals for Rockaway seniors may soon be in jeopardy. Catholic Charities refused to comment on any of The Department for the Aging proposals until plans are finalized.

As part of Mayor Bloomberg's "All Ages Project," 15,000 Meals on Wheels recipients, including hundreds in Rockaway, face a major overhaul to the program that could reduce their daily food deliveries to just two days a week.

Under the proposed plan, Meals on Wheels services will become regionalized under a set of vendors who will deliver frozen meals to select seniors twice a week, leaving them to heat up the meals themselves, rather than the present system, which has local people delivering hot meals to homebound seniors on a daily basis.

The Department for the Aging says the modernization is necessary to prepare for the growing senior population that is expected to rise 44 percent by the year 2030. Using the current system, the Department argues the agency would be overwhelmed and incapable of serving such a large number of seniors.

By 2030, there will be an estimated 1.35 million seniors residing in New York City. Chris Miller, spokesperson for The Department for the Aging, says that the program will open an array of options to seniors that weren't previously available.

"There is no loss of a meal for any senior," Miller says. "It is not a budget decision, it is to allow choices, expand our menu, and serve more seniors."

The local plan would be based on the agency's new program called, "Senior Options," which started as a pilot in the Bronx during 2004.

According to Miller, under the proposed plan, seniors would essentially be given the choice of hot daily delivered meals or twice a week delivery of frozen, ready to heat meals.

"We have a lot of seniors that have become frightened recently that they will only be getting frozen meals," he said. "They will have the choice based on an individual evaluation by their case manager."

"Our goal is not to save money, but rather to serve more seniors," Miller said.

Local politicians, who see an expanding base of senior voters and a large number of senior homes on the peninsula, are skeptical about the plan, its benefits and whether or not it's necessary to change a program that has worked so well in the past.

State Assemblywoman Audrey Pheffer, who told The Wave that, "It's all about saving the money," contends that she will do everything in her power to delay this plan from going into effect. The proposal will be formally requested on March 31 for Mayor Bloomberg to review.

"The study done in the Bronx with this program showed that it didn't save any money," she said. "Don't fix something that isn't broken. This program has worked for a long time, there's no need to change anything."

The purpose of Meals on Wheels is to serve the frail elderly who cannot cook for themselves. Therefore, logic should follow that an individual who is frail, elderly and too weak to cook would not fair well on a frozen meal regimen.

Pheffer continues to say this change defies the entire purpose of the program.

"If they are capable to heat up their own home delivered meal that means they really don't need Meals on Wheels. It exceeds eligibility."

Another non-monetary component to the daily Meals on Wheels deliveries is the human element, according to the assemblywoman. The idea is more than just a meal, but rather the human contact and socialization that a homebound elder receives when the person comes to his or her door with the food.

"The human contact is an essential part of the process," Pheffer said. "These deliveries serve as a lifeline to seniors."

Pheffer added that there are times when a delivery person comes into a home and sees the elder unconscious, in very poor condition, or visibly not feeling well. They can then report back to a case manager who comes out to visit the senior and check up on him or her.

This element would be lost if regionalized vendors take over individual accounts and make visits only twice a week.

Pheffer believes regionalized vendors will also eliminate the diversity seen in various Meals on Wheels neighborhoods.

Currently there are several different Meals on Wheels options depending on the demographic makeup of a neighborhood. Meals include Kosher, Middle Eastern and other distinct foods that represent what the people of those particular neighborhoods prefer to eat.

"We haven't been shown how this helps frail and elderly people," Pheffer said. "They want to regionalize Meals on Wheels and I really don't know why, we would lose all the diversity associated with it."

City Councilman James Sanders, Jr. met with The Department for the Aging Commissioner Edwin Mendez- Santiago this week to discuss the "Senior Options" plan.

Sanders' preliminary thoughts were similar to those of Pheffer.

"These meals serve as lifelines to our seniors," he said. "They are not simply meals."

Sanders, however, was happy to hear about the increase in caseworkers throughout the city.

"More human contact and connection with the seniors is great, as long as it is done in a humane and neighborly way that is beneficial to the seniors," Sanders said.

Sanders continued to say that the commissioner assured him these will not be traditional frozen meals. Rather they will be what he described as "flash-freeze" meals.

A method that ensures all key nutrients and vitamins are preserved in the meal which still has a fresh taste when heated up.

"That remains to be seen," Sanders said in response. "Right now I am not sure if this is the best way to approach this program."

Sanders assured his constituents that he will remain on top of the issue and continue to monitor it.

"We need to protect the best interests of ourselves," he said. "Our seniors services are an important part of this community. We don't want anything forced upon us that isn't in our best interests."