Here are the numbers every New Yorker should see side by side.
Since 2010, New York’s Medicaid spending has grown 123%, from $51.8 billion to an estimated $115.6 billion a year. The budget for this year funds a $122.6 billion program.
Over the same period, criminal Medicaid fraud enforcement collapsed:
- Convictions fell 75%, from 102 in 2010 to 25 in 2025.
- Fraud indictments fell 92%, from 83 in 2010 to 7 in 2025.
- Annual average: From 2010 through 2019, the state’s fraud unit averaged 71 convictions a year. Since 2020, it has averaged 15.
The program more than doubled, and the number of people charged and convicted for stealing from it collapsed.
This summer, the federal government made the failure official. On June 30, the U.S. Health and Human Services Inspector General denied recertification of the Attorney General’s Medicaid Fraud Control Unit and suspended roughly $60 million in federal funding, finding it the lowest-performing unit among similarly sized states.
The Attorney General’s office says the unit recovered $627 million in civil settlements from 2019 to 2025, and that’s real money. But a settlement is a check. A conviction is accountability.
Now ask who else was supposed to be watching.
Consider what reporters found this August. A New York Post investigation looked at social adult day care centers in Flushing, Queens. One, Livingwell, billed Medicaid about $27 million from 2018 to 2024 for more than 26,000 patients. Its annual billing grew from roughly $114,000 to over $8 million.
When Post reporters visited, they found no patients. Another, Bao Kang, is tied to an owner whose businesses have billed at least $32 million since 2018, and it was empty too. Neither owner has been accused of wrongdoing, and there may be explanations. But numbers like these should trip an alarm long before a reporter walks through the door.
The data was public. Someone had to look. That is the auditor’s job.
Thomas DiNapoli has been New York’s chief auditor since 2007, responsible for following the taxpayers’ money in the largest program the state runs. His office has audited Medicaid and joined a few cases. But against a program that has more than doubled, I can’t point to a sustained public campaign to stop the losses, and the flags his own auditors raised did not become reform.
A 2024 audit by his office found no electronic visit verification records for 44% of personal care claims, about $14.5 billion in payments. Finding the problem is the start of the job. Voters deserve to hear what came next.
I’ll be fair about what this data does and doesn’t show. Spending growth is not proof of fraud. Enrollment, wages, and health costs have all pushed Medicaid up. And prosecutions belong to the Attorney General and district attorneys, not the Comptroller. I’m not claiming DiNapoli ran the fraud unit.
My claim is simpler. When spending more than doubles and indictments fall by more than 90%, the state’s auditor should be demanding to know why, loudly, publicly, and every year.
As Comptroller, I’ll build a Fraud Strike Team inside the office. It won’t prosecute, because that’s not the Comptroller’s job, but it will do what the Comptroller can do:
- Go where the risk is. Start with Medicaid, including home care agencies, adult day care, non-emergency medical transportation, and the CDPAP fiscal intermediary transition.
- Use data, not reporters. Analyze claims to flag patterns like Livingwell’s before a newspaper does, then refer suspected fraud straight to prosecutors and the Office of the Medicaid Inspector General.
- Report every quarter. Publish how many referrals were made, how many became cases, and how many ended in convictions.
- Name the gaps. When a referral goes nowhere, say so, and say where it stopped.
Sunlight is the point. Nobody can look the other way when the numbers are public.
Medicaid exists to care for people who need it, and that mission is corrupted every time a dishonest provider bills for care that was never delivered. Honest providers and patients are cheated when fraud goes unpunished. Taxpayers are cheated too.
New York doesn’t need another 19 years of an audit office that watches the bill climb. It needs a Comptroller who counts every dollar, asks who is accountable, and publishes the answer.