Excess Medicaid Payments Cost State $33 Million
July 27, 2012
Around Town By Neal Tepel
The State Department of Health (DOH) made $32.9 million in Medicaid overpayments during a five-year period due mainly to the issuance of multiple identification numbers to Medicaid recipients, according to two audits released by New York State Comptroller Thomas P. DiNapoli. A third audit found $24 million in missed savings for physician-administered drugs.
“Due to a lack of basic oversight, overpayments such as these continue to plague the system,” said DiNapoli. “Previous audits have identified nearly $100 million in Medicaid overpayments resulting from people with multiple identification numbers and missed savings opportunities. There is no reason these problems should persist."
Audits continue to indicate improper managed care payments. DOH overpaid Medicaid providers $17.3 million from 2007 through
2010 because local social services districts improperly assigned multiple identification numbers to nearly 10,000 enrollees. between 2005 and 2010, DOH made $15.6 million in improper managed care payments on behalf of 14,899 foster and long-term care recipients who, by state law, were precluded from enrollment in managed care programs.
New York has 58 local social services districts which cover residents in the counties throughout the state, except New York City – where the five boroughs comprise one local district. These districts determine Medicaid eligibility requirements and enroll recipients in fee-for service or managed care programs. Auditors found these districts provided 9,848 recipients more than one identification number — nearly 90 percent of these instances stemmed from the New York City Human Resources Administration.