Report on New York Audits: $14.5 Billion of $31.5 Billion in Medicaid Personal-Care Payments Lacked Matching Visit Records

A new report built from New York State Comptroller audits finds billions of dollars in Medicaid and unemployment payments that were never fully verified, Fox Business reports.

The authors. The State Financial Officers Foundation and OpenTheBooks.com reviewed Comptroller findings from 2018 to mid-2026 on Medicaid, unemployment insurance, local governments and affordable housing.

Medicaid. New York paid about $31.5 billion for personal-care services from January 2021 to March 2023. About $14.5 billion, or 46%, lacked matching electronic records showing when the services happened or how long they lasted. A 2024 audit found the state had a system that could block such payments without the required visit records, but the feature was not turned on. Auditors also flagged $21.3 million in potentially improper payments, such as visits billed while patients were in the hospital, and nearly $1.2 billion in managed-care premiums for people who may no longer have lived in the state.

Unemployment. The report cites an estimated $11 billion in improper pandemic-era payments, out of $76.3 billion paid in fiscal 2020-21. The state's system had been flagged as outdated as early as 2010 and was not replaced before the pandemic.

Smaller cases. A fire company treasurer in Oswego County took more than $850,000 over more than eight years, and a town court clerk stole nearly $60,000. In the city's Mitchell-Lama housing program, auditors found vacancies above city limits and more than $9 million in lost rent.

Note for readers: Fox stresses the missing records "do not establish" that payments were fraudulent or services never happened, and the $11 billion figure is an extrapolation, not confirmed fraud. The state Health Department disputed aspects of the findings, and Comptroller Thomas DiNapoli's office says its audits help root out fraud. The report says the figures cannot be added into one taxpayer loss.