Audit: State made $1B-plus in unnecessary Medicaid payments

New York state's comptroller says the state Department of Health paid more than $1 billion in Medicaid coverage premiums over a six-year period for people who already had private insurance coverage.

Posted: Jun. 13, 2018 4:33 PM

ALBANY, N.Y. (AP) - New York state's comptroller says the state Department of Health paid more than $1 billion in Medicaid coverage premiums over a six-year period for people who already had private insurance coverage.

Comptroller Thomas DiNapoli says Wednesday an audit of the department's payment system found "glitches" and other problems resulted in $1.28 billion in Medicaid managed care premiums being paid for enrollees already covered by private insurance.

The state health department manages the program that provides health care services to the poor and those with special health care needs.

DiNapoli says most of the payments to managed care organizations are unrecoverable because of Medicaid rules.

His recommendations include improving the agency's monitoring efforts to prevent, detect and recover inappropriate premiums.

Health department officials say they're reviewing Medicaid programs and working to prevent unnecessary payments.

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