State audit finds more than $16 million in Medicaid cost savings

WRGB

Jul 25, 2017

New York State Comptroller Thomas DiNapoli announced an audit of the state's Medicaid system revealed millions in overpayments. DiNapoli's office says Medicaid could have saved New York taxpayers $13.6 million spent on patients with severe kidney disease whose expenses could have been covered by the federal Medicare program. An additional $3 million in cost savings were also found, but the Comptroller says about $1.8 million of that had been recovered before the close of the audit.

New York's Medicaid program is run by the state Department of Health.

The Comptroller's Office says a previous audit of the DOH found that it did not identify Medicaid recipients with ESRD, notify them of their entitlement to Medicare or take actions to help them enroll in the federal program. Officials say corrections from that audit have not yet been completed at the time of the most recent audit's release.

DiNapoli says auditors also found $1.1 million in improper payments to home health care providers; more than $845,000 in overpayments for newborn claims submitted with incorrect birth weights; $471,321 in overpayments for claims billed with incorrect information pertaining to recipients' other health insurance coverage; $357,498 in improper payments for inpatient, durable medical equipment, clinic, child care and transportation services; $160,759 in overpayments for an inpatient claim that was billed at a higher level of care than what was actually provided; $25,354 in improper payments for duplicate billings.

The Comptroller's office is recommending that the DOH recover the inappropriate payments.