Taxpayers Stiffed – Receipts Missing

Hand holding a disintegrating hundred dollar bill. — Photo: Shutterstock

New York’s own audits point to billions paid with weak proof, and taxpayers are left holding the bag.

Story Snapshot

State audits flagged $14.5 billion in Medicaid home-care claims without required visit verification.
The Comptroller estimated about $11 billion in improper pandemic unemployment payments.
Health and Labor officials dispute methods and totals, but promise fixes.
Small audit samples also found millions in specific improper Medicaid payments.

Audits Show Big Holes In Medicaid Controls

New York’s Comptroller reported that Medicaid paid $14.5 billion for home-care services without matching electronic visit verification records over several years. That means the state paid without the required proof that a worker was at the right place for the right time with the right patient, a basic safeguard against fraud and billing errors. Separate Comptroller audits found hundreds of millions routed to providers who did not appear to be enrolled and more recent claims the state’s payment system should have denied but paid anyway.

🚨 New report on New York’s taxpayer dollars:
• $14.5B in unverified Medicaid payments
• $11B in improper unemployment payments
• $1.2B potentially paid on behalf of people who may no longer live in the state

The Comptroller says oversight is working. The numbers raise… pic.twitter.com/6tnyc7Cgd4

— State Financial Officers Foundation (@SFOF_States) October 27, 2026

State Health officials pushed back on parts of the verification count. They argued timing differences in how data were pulled explain some missing records, and they stressed that a missing visit file does not prove the care never happened. They still pledged to review the unmatched claims, tighten provider guidance, and step up oversight. That matters. The state’s own policy says steady noncompliance can trigger audits and clawbacks. Promises now need receipts and recoveries.

Pandemic Unemployment Payments Went Out Fast And Loose

The Comptroller’s unemployment audit traced billions in improper payments to an outdated claims system and quick fixes during the pandemic crush. The analysis applied a federal fraud rate to more than $76 billion paid and estimated roughly $11 billion in losses. The Office tied that to long-known system gaps and weak identity checks that let bad claims slip through when volume spiked and rules shifted. The pattern mirrors national findings that emergency speed raised fraud risks.

The Department of Labor rejected the estimate and said the Comptroller used a tiny sample and a flawed model. The agency projected about $4 billion in potential fraud across both federal and state unemployment programs, with only $388 million tied to state benefits. Leaders said the current system now blocks 97 percent of fraud attempts before any money goes out and cited a four-year tech overhaul, tougher screening, and public dashboards to track progress. Those are welcome, but the bill for past errors remains.

Small-Dollar Audits Reveal A Larger Culture Problem

Auditors also caught improper Medicaid payments in targeted six-month reviews, such as $16.2 million that the state’s payment system should have denied but paid anyway, and another period with $12.1 million flagged across premiums and claims. These are not headline numbers, but they point to control rules that do not fire, edits that do not stop bad bills, and vendors that learn how to route around weak checks. When small samples show steady leaks, the full pool likely loses far more.

Conservative common sense sets a simple test: pay only for what you can prove. That means verified visits for care, enrolled providers for claims, strong identity checks before unemployment money leaves the building, and fast clawbacks when rules fail. New York’s audits show the state did not always meet that test. Agencies dispute parts of the math, but even their lower figures accept billions at risk or in error. Speed is not an excuse five years later. Fix the pipes, then recover what spilled.

What Accountability Should Look Like Now

Lawmakers should require quarterly public scorecards on Medicaid visit verification match rates, denials, and recoveries, plus a list of providers under review. The Health Department should suspend repeat noncompliant agencies pending audit outcomes, with accelerated clawback timelines. The Labor Department should publish fraud-stopped metrics with clear baselines, not just percentages, and reconcile the gap between its projections and the Comptroller’s estimate with an independent review. Taxpayers deserve proof, not promises.