New York State Audits Find $92 Million in Medicaid Overcharges

Auditors found that the Health Department paid more than $53 million to almost 26,000 recipients who had multiple Medicaid identification numbers, DiNapoli said today. Health officials “are only taking action to recover $2.4 million” because they can’t determine who was overpaid, he said.

“Our audits keep finding that the safeguards designed to detect waste, fraud and abuse have failed over and over again,” DiNapoli said in a statement. “The Department of Health has to start protecting the taxpayers’ money.”

The audits come as Governor David Paterson seeks $150 million in Medicaid-fraud savings to help close a $3.1 billion deficit. Previously in 2009, examinations of the state’s $45 billion a year Medicaid program for the poor found $169 million in overpayments and lost savings, DiNapoli said.

“Medicaid is a complex program and it’s not easy to make it foolproof,” said Claudia Hutton, a spokeswoman for the state Health Department. “Ideally, no claim would ever be inappropriately paid and any would be immediately recouped. The comptroller is not at odds with most of what we do.”

Auditors found $21.5 million in incorrect or improperly handled claims through the Health Department’s eMedNY processing system, DiNapoli said. Auditors stopped the department from paying $20.3 million in claims submitted with the wrong reimbursement rate, which had been mistakenly changed to $15,151 from $148, the comptroller said.