The state of New York has recouped about $2.3 million in Medicaid overpayments that occurred from April 1, 2010, through Sept. 30, 2010, according to a report from the New York Office of the State Comptroller.
The Office of the State Comptroller conducted an audit to see if the New York Department of Health's eMedNY payment system ensured Medicaid claims were submitted by approved providers, processed in compliance with requirements and resulted in correct payments.
In that six-month period, eMedNY processed approximately 163 million claims resulting in payments to providers of about $24 billion. The audit found the actual and potential overpayments totaled roughly $2.9 million, of which $2.3 million had been recovered.
According to the report, the auditors found seven reportable conditions, including:
• About $1.4 million in overpayments resulting from improper claims from out-of-state hospitals.
• Roughly $635,000 in overpayments for claims that had incorrect Medicare eligibility information or incorrect Medicare reimbursement amounts.
• About $550,000 in overpayments that involved inpatient stays for intensive levels of care that should have been based on less costly levels of care.
Additionally, auditors discovered that 21 providers who received Medicaid funds had been charged with abusing Medicaid, Medicare or other health insurance systems. The Department of Health terminated eight of those providers.
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The Office of the State Comptroller conducted an audit to see if the New York Department of Health's eMedNY payment system ensured Medicaid claims were submitted by approved providers, processed in compliance with requirements and resulted in correct payments.
In that six-month period, eMedNY processed approximately 163 million claims resulting in payments to providers of about $24 billion. The audit found the actual and potential overpayments totaled roughly $2.9 million, of which $2.3 million had been recovered.
According to the report, the auditors found seven reportable conditions, including:
• About $1.4 million in overpayments resulting from improper claims from out-of-state hospitals.
• Roughly $635,000 in overpayments for claims that had incorrect Medicare eligibility information or incorrect Medicare reimbursement amounts.
• About $550,000 in overpayments that involved inpatient stays for intensive levels of care that should have been based on less costly levels of care.
Additionally, auditors discovered that 21 providers who received Medicaid funds had been charged with abusing Medicaid, Medicare or other health insurance systems. The Department of Health terminated eight of those providers.
Related Articles on Medicaid Overpayments:
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Maine Discovers $66M in Medicaid Overpayments