Taxpayers Outraged, Billions Gone

Dollar bill disintegrating while held by hand. — Photo: Shutterstock

New York’s own auditors say billions left the treasury with little proof anyone earned it.

Story Snapshot

State audits cite massive gaps in Medicaid and unemployment controls.
About $14.5 billion in home-care claims lacked required visit verification, auditors say.
The Comptroller estimated about $11 billion in pandemic unemployment fraud; Labor disputes it.
Agencies promise fixes, but repeat audits keep finding fresh errors.

Auditors flag missing proof behind billions in Medicaid home care

New York State Comptroller auditors reported that Medicaid paid about $14.5 billion for personal-care visits without matching electronic verification records. That system should confirm who showed up, for how long, and where. The Department of Health pushed back, saying timing differences in data pulls explain part of the mismatch and that a missing record does not prove the care never happened. The agency still pledged tighter guidance and reviews to recover overpayments if found.

🚨 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

Separate Comptroller audits show other weak spots. Medicaid managed-care plans sent as much as $1.5 billion to providers who did not appear properly enrolled during the review period. That happened over several years and across plans, pointing to basic enrollment checks that failed or lagged. The Department of Health’s eMedNY system also paid improper claims in multiple samples, including more than $16 million over six months beginning October 2023, despite edits meant to block errors.

Pandemic unemployment systems buckled under scale and speed

The Comptroller tied an estimated roughly $11 billion in improper unemployment payments to an outdated state system and ad hoc workarounds during the pandemic surge. Auditors said long-known risks went unfixed, then broke under record claim volume. The New York Department of Labor rejected the estimate. Officials said the Comptroller extrapolated from a tiny sample using a flawed model and pegged potential fraud closer to $4 billion across federal and state benefits, with $388 million tied to state benefits.

The clash mirrors a national story. The United States Government Accountability Office reported broad, documented fraud in pandemic unemployment programs and placed total fraud in a range of about $100 billion to $135 billion, or roughly 11 to 15 percent of benefits, using national sampling and imputation methods. That context shows two truths at once: emergency speed bred fraud, and estimates can swing based on methods and data access.

What the pushback gets right—and what taxpayers should demand next

State agencies argue that audits often catch paperwork gaps more than theft. They note that a missing electronic visit record can reflect late uploads, not fake care, and that identity rings, not agency staff, drove much of pandemic unemployment fraud. Those points deserve weight. But when core safeguards—verification of a visit, proof a provider is enrolled, edits that stop duplicate bills—do not trigger every time, taxpayers subsidize sloppiness. That offends common sense and conservative values of stewardship and fairness.

Fixes are on paper. Health officials say they will tighten provider guidance, enforce data matches, and refer chronic offenders for audits and clawbacks. Labor officials say they are deep into a four-year overhaul and now stop most fraud attempts before money goes out. Progress should show up where it counts: fewer repeat findings, fast recovery of bad payments, and clean trend lines in new audits. Until then, the pattern of recurring errors suggests controls remain too easy to bypass.