Staff Reports
New York’s social adult day care program is finally under the microscope — and that’s a good thing. After state and federal agents swooped on more than 100 adult day care providers in a fraud sweep, Governor Kathy Hochul ordered the State Department of Health to study whether the Medicaid benefit should be tightened, overhauled, or phased out entirely. For taxpayers and honest providers, this review can’t come fast enough.
Fraud, waste and the price tag taxpayers are paying
The scope of the problem is startling: auditors found about $285 million in questionable payments tied to adult day care claims, and managed care plans paid roughly $2.4 billion for these services from 2019 through 2024. State officials say more than 400 programs serve some 45,000 Medicaid beneficiaries and cost more than $500 million a year. CMS Administrator Dr. Mehmet Oz called the enforcement action “the largest of its kind.” When the numbers are in the billions and federal investigators show up, that’s not a glitch — it’s a systemic failure.
Enforcement isn’t enough — policy change is needed
Arrests and audits are welcome, but they are only part of the fix. Governor Hochul has rightly ordered prepayment reviews and a tougher posture by managed care plans, and she’s kept a moratorium on new providers. Still, the Department of Health must answer a bigger question: can better oversight save this benefit, or should New York end the social adult day care benefit and shift people into safer, better‑monitored services? Any real answer will require federal approval through CMS, so state leaders should be ready with a tight transition plan for current beneficiaries.
Protect seniors, punish crooks, and stop the gravy train
Conservative common sense should lead here: protect seniors who need daytime supervision and social care, but stop throwing taxpayer dollars at programs that let fraudsters siphon money. That means aggressive recoupment where audits show questionable payments, clear rules to boot bad actors out of the system, and strong penalties for managers who look the other way. If the program proves too rotten to save, phase it out — but don’t abandon the people who depend on care. A smart transition would move beneficiaries to verified home‑and‑community services or other Medicaid options that come with proper oversight.
New Yorkers deserve accountability, not excuses. The governor’s review gives the state a chance to clean up adult day care fraud, recover lost taxpayer dollars, and rebuild a system that serves seniors instead of lining the pockets of criminals. If Albany uses this moment to tinker around the edges, taxpayers and vulnerable adults will keep paying the price. Time to stop pretending and start fixing it.
