Billions Vanish – No Proof

Hundred-dollar bills disintegrating in hand. — Photo: Shutterstock

New York’s own audits say billions left the treasury with little proof they were earned or owed.

Story Snapshot

Audits flagged $14.5 billion in Medicaid home-care claims without required visit verification.
The State Comptroller estimated about $11 billion in improper pandemic unemployment payments.
Health and Labor officials dispute parts of the findings and cite fixes under way.
The pattern mirrors national gaps that turned speed into waste during the pandemic.

Audits Expose Gaps That Cost Billions

New York State Comptroller Thomas DiNapoli’s team found major holes in two safety-net programs. One audit reported that Medicaid paid $14.5 billion for home-care services without matching electronic visit verification records, the time-and-place proof meant to confirm aides actually showed up. Another review estimated roughly $11 billion in improper unemployment payments during the pandemic, tied to an outdated system and rushed workarounds that weakened checks. These are not internet rumors. These are the state’s own audits.

🚨 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

The numbers are large because the programs are large. Medicaid touches millions of residents and billions in claims flow through automated systems each month. Unemployment insurance surged when the economy shut down. Controls that work at normal speed often buckle when volume spikes. That does not excuse missing proof. It explains how money moves out the door when the guardrails bend. Taxpayers deserve speed and accuracy, not a choice between them.

What “Unverified” Means And Why It Matters

Electronic visit verification tracks who provided a service, to whom, where, and when. Federal law requires it for many home-care visits. Without a matching record, the state cannot easily prove the visit happened. The audit did not call every dollar fraud. It did say the claims lacked the basic check the state chose to rely on. In any business, paying invoices without required proof would trigger clawbacks and terminations. Government should meet that same bar, if not a higher one.

New York’s Department of Health pushed back. Officials said timing differences affected the count and that missing electronic visit verification by itself does not prove a service was improper. They pledged to review the flagged claims, tighten guidance, and step up compliance work, including potential recovery of overpayments where rules were broken. That response accepts the core duty: when proof is missing, you verify, correct, and, if needed, get the money back.

Unemployment Errors: Competing Estimates, Shared Warning

The Comptroller tied his unemployment estimate to weaknesses in the legacy system and emergency workarounds during the pandemic. The New York Department of Labor rejected the $11 billion figure, calling it an extrapolation from a tiny sample and an outdated model. The agency projected about $4 billion in potential fraud across federal and state benefits, with $388 million tied to state unemployment insurance. The department also said it now blocks most fraud attempts before any money goes out.

National watchdogs back the idea that pandemic unemployment programs leaked badly. The United States Government Accountability Office estimated total unemployment insurance fraud nationwide was likely between $100 billion and $135 billion, or about 11 to 15 percent of benefits paid, using sampling and imputation methods. That range does not settle New York’s exact figure, but it shows the state’s problem fits a larger pattern. When programs pay first and check later, losses mount fast.

Follow The Controls, Not The Politics

The headline numbers grab attention; the control fixes will save the money. The Comptroller’s office has also found smaller, concrete errors that add up: millions in improper Medicaid payments from system logic gaps, premium mistakes, and payments to providers who did not appear properly enrolled. These are nuts-and-bolts problems that strong systems can catch before payment. Conservative common sense says enforce the rules at the front door, and you avoid chasing dollars down the street later.

Policy should focus on three steps. First, verify before paying whenever the law allows. Second, publish real-time dashboards so the public can see error rates drop, not just hear promises. Third, make recovery the norm, not the exception, when providers or claimants cannot prove eligibility or service. New York’s health and labor agencies say they are modernizing and reviewing flagged claims. The test is not the press release. The test is fewer bad payments next quarter—and money recovered from the last one.