From Associated Press
ALBANY, N.Y. — State auditors say data problems and information delays at New York’s Medicaid claims processing system have caused $36 million in improper payments and another $6.3 million in overpayments.
State Comptroller Thomas DiNapoli said that $3.2 million has been recouped and the health department says it has changed practices.
An audit of Medicaid managed care plans for three years, examining premium payments for “dual-eligible” enrollees who are also in Medicare or other federal programs, says there were unnecessary payments on behalf of 45,000 people due to delays in posting Medicare data and then removing those people from managed care plans.
A second audit noted actual and suspected overpayments during six months when eMedNY processed approximately 174 million claims resulting in payments to health care providers of about $25 billion.
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