FLUSHING, NY — Republican nominee for New York State Comptroller Joseph Hernandez today blasted Comptroller Tom DiNapoli for failing to address massive oversight gaps in New York’s social adult day care system, despite his own office warning more than a decade ago that the state could not properly track the programs, their operators, or the quality of services being provided.
Independent journalist Nick Shirley and Centers for Medicare and Medicaid Services Administrator Dr. Mehmet Oz recently investigated adult day care centers in Flushing, Queens, where Oz says Queens generates approximately $2.1 billion within the industry. At one center, public data reportedly showed nearly 8,000 participants in one year and millions of dollars in government payments. When Shirley questioned employees, they denied serving anywhere near that number.
“An independent journalist with a camera exposed more obvious warning signs in a few days than DiNapoli prevented in 19 years as Comptroller,” Hernandez said. “Nick Shirley walked through the front door, looked at the numbers, and started asking the questions New York’s fiscal watchdog should have been asking for years. Where has DiNapoli been?”
DiNapoli cannot claim he did not know the system was vulnerable. His own 2015 audit found that social adult day service programs were not licensed or registered by any single government agency, estimated that at least 500 programs were operating statewide, and admitted there was “no way to track” how many additional centers may have existed. The report also warned that without comprehensive oversight, the precise number of providers, their costs, who was running them, and the quality of their services were unknown.
More than a decade later, the scale of the program and the warning signs have only grown. Enrollment in New York’s social adult day care program has surged 59%. The number of participating centers declined approximately 4%, while annual spending climbed to roughly $604 million, representing 17% of all Medicaid adult day care spending nationwide. A full-time participant can cost taxpayers more than $3,200 per month, and one Flushing center with capacity for 323 people reportedly billed for 530 participants in a single day.
“This did not happen because the warning signs were hidden,” Hernandez said. “DiNapoli’s own office identified the lack of oversight in 2015, yet he allowed the same weaknesses to continue while enrollment surged, spending exploded, and questionable payments piled up. An audit after the money is gone is not oversight. It is an autopsy.”
DiNapoli’s latest audit reviewed approximately $2.4 billion in payments and identified more than $285 million in questionable Medicaid payments, including $28.6 million paid to centers terminated for fraud, waste, abuse, integrity, or quality concerns. Federal prosecutors have also charged two Queens men in an alleged $120 million Medicare and Medicaid fraud scheme involving illegal kickbacks, bribes, and claims for services that were never provided.
As Comptroller, Hernandez will establish a Fraud Strike Team made up of forensic accountants, advanced data analysts, experienced investigators, and former prosecutors. The team will use real-time auditing and artificial intelligence to identify impossible attendance figures, duplicate claims, sudden billing spikes, claims for absent participants, and suspicious relationships between day care centers, pharmacies, transportation providers, and managed-care plans before taxpayer money is paid out.
“The Comptroller’s job is to stop fraudulent checks before they clear, not publish another report after hundreds of millions of dollars are already gone,” Hernandez said. “DiNapoli knew the system was broken and failed to fix it. Taxpayer dollars belong to New Yorkers, not fraudsters. Follow the money, audit everything, and prosecute anyone who steals from the people of New York.”