The New York City Council is pulling out all the stops to halt the spread of social day care centers that rip off Medicaid. The New York Times is reporting that the Council is looking to implement regulation and enforcement in order to weed out the shady centers that lure in healthy seniors in order to reap a windfall in Medicaid benefits.
In April, we first reported on the proliferation of social day care centers, which exploded from just eight programs citywide to 192 in only two years. The facilities arose in the wake of a new law enacted by Governor Andrew Cuomo, which wished to curb Medicaid costs by steering seniors needing expensive in-house or nursing care to the less-costly, community-friendly centers. The centers are supposed to treat patients with severe disabilities and medical problems but instead, many have been tapping healthy seniors to participate, luring them with cash and free groceries. The Times explains how the managed care plans and social centers profit by this practice:
Under the new system, managed care plans get roughly $3,800 a month for each eligible person they enroll in New York City, regardless of what services are provided. The plans contract with the social adult day care centers to provide services to their members. But advocates for the elderly and for people with disabilities have warned state officials that some plans were “cherry-picking” healthy seniors by using the new day care centers as marketing tools, while shunning the people who needed hours of costlier home care.
Joan Pastore, director of Amico, a city senior center in Dyker Heights, Brooklyn, said members of the center told her that they were not only signed up by new centers with enticements like $100 in cash and $50 for bringing a friend, but “coached on how to lie to qualify for home care.”
Members of the Council expressed anger at the practices of the managed care plans and the social day care centers.
“It is just outrageous that these pop-up centers are threatening the well-being of our seniors while draining Medicaid resources from legitimate programs for older adults. Increased oversight and regulation of these programs is needed immediately,” City Council Speaker Christine Quinn told the Times.
In response, the Council has introduced a bill that would impose minimum requirements on the centers, which as of right now, are unregulated. Centers would be limited to treating seniors with impairments, set minimum safety standards and must register with the city’s Department of Health and Mental Hygiene. The bill would also protect centers that play by the rules and offer robust service to patients with actual disabilities.
Centers that don’t register or ignore the new rules could be fined between $250 to $1,000 a day. Enforcing these new rules won’t be cheap. City officials estimate that it will cost $2 million to police the nearly 200 centers throughout the city.
State Senator Diane Savino is looking to create a statewide bill that is modeled after the Council version.