Recently, incidents of fraud and abuse related to the Medicaid program, known as “白卡” (Medicaid) in the United States, have been exposed in various regions of New York. These cases involve amounts ranging from hundreds of thousands to tens of millions of dollars, covering services such as adult day care, home care, and medical transportation. Community leader Yu Jinshan in Chinatown pointed out that these cases illustrate significant loopholes in the management and oversight of certain welfare programs. However, he also emphasized that the Medicaid system itself remains an important social safety net for low-income individuals, the elderly, and people with disabilities.
One of the most prominent cases in recent days is the Medicaid fraud case at a Brooklyn adult day care center. On January 15th, two suspects confessed to being involved in a fraudulent scheme totaling up to $68 million. Prosecutors revealed that the suspects submitted false bills to Medicaid for adult day care and home medical services, enticing Medicaid beneficiaries with kickbacks and various incentives while not actually providing the services they claimed, thereby severely undermining public healthcare resources.
In addition, the local prosecutor in Orange County and the New York State Comptroller disclosed what was described as one of the “largest scale” Medicaid fraud cases to date. A couple running a medical transportation company was charged with submitting nonexistent or duplicate trip and mileage records to the New York State Department of Health over a four-and-a-half-year period, illegally obtaining nearly $3 million in Medicaid subsidies. The couple was officially indicted and arrested on October 30, 2025.
In response to these incidents, Yu Jinshan, the Democratic leader of the 65th District in Manhattan’s Chinatown, reiterated that the legislative intent of the Medicaid program is to supplement basic health insurance gaps for residents with insufficient income or limited physical conditions. It also extends to welfare services like elderly day care to help seniors maintain social and mental well-being, thus reducing overall societal costs for future healthcare expenditures. He emphasized, “The system itself is not the issue; the problem lies in its implementation and management.”
Yu Jinshan further pointed out that one of the controversies surrounding the Medicaid program is that a small number of individuals with sufficient assets who qualify through legal means are not truly part of the vulnerable groups, leading to the occupation of limited welfare resources. He also stated that currently Medicaid is mostly executed and allocated by health insurance companies, including medical services, caregiver arrangements, and referrals to elderly facilities. However, government oversight primarily focuses on the health insurance companies themselves, lacking direct and unified government supervision over the elderly and grassroots service providers, ultimately resulting in a structural problem where “everyone seems to be in charge, but no one is actually responsible.”
“The original intent of the Medicaid legislation is not wrong; the issue lies in the breakdown of the entire management chain from state government, health insurance companies to grassroots service providers,” Yu Jinshan emphasized. Without comprehensive planning and effective supervision, systemic loopholes will naturally be exploited, leading to repeated incidents like these.
In response to Medicaid fraud, the New York City government currently provides an official complaint mechanism through “NYC311” for reporting public welfare and Medicaid fraud, encouraging the public to report any suspicious activities.