It should be obvious after the July 3 announcement of two Medicaid fraud cases totaling $3.4 million that the state must make major changes to its Non-Emergency Medical Transportation system.

The system is a necessary one that relieves the stress of non-emergency transportation to medical appointments from ambulance companies while helping those who can’t get rides from friends or family members to get to medical appointments. Companies providing rides are paid through the state’s Medicaid program.

For years these rides were arranged by counties throughout the state, but the state changed the system to remove approval from counties and instead dispatch medical transportation through brokers.

Those brokers, too often, are stealing your money. It’s a scam as old as time itself – overcharge people to get more Medicaid money, bill for fake trips and bill for fake tolls, make small payments to Medicaid patients to get them to use a provider and then overcharge Medicaid for the service. Small amounts of money here and there eventually add up to millions of dollars in waste and fraud – and it’s hard to catch unless people get too greedy, as happened with the two Central New York companies whose owners now face criminal charges.

State officials reformed the program in 2020 as part of an effort supported at the time by state Sen. George Borrello, who has been sounding the alarm about fraud in the non-emergency transport system since he earned election to the state Senate. Those reforms didn’t work. There’s still fraud in the program.

What’s galling is everyone in power in Albany seems to know the system stinks. State Comptroller Thomas DiNapoli has called for reform. Democrats in the state Senate, when Borrello brings the issue up, shrug their shoulders and change the subject. There seems to be no political will to reform this one small corner of the state’s staggering $34.7 billion Medicaid budget.

That should change in January. Rather than spend months writing chapter amendments to unforeseen flaws in legislation passed this year, the first order of business on the legislative agenda when the state Legislature reconvenes in January should be to return non-emergency transport services to counties and end this state-backed broker system that has proven, year after year, to be a waste of millions of dollars.

If state lawmakers can’t fix the fraud in an admittedly small corner of the state’s Medicaid budget, why should we trust them to do the right thing with the rest of the state’s massive budget?