Department of Health

Implementation of eMedNY

New York State’s Medicaid program is administered by the Department of Health. Medicaid claims are processed and paid by an automated system that is operated by a contractor. In 2000, Computer Sciences Corporation (CSC) was awarded a contract in which it was supposed to develop a new and enhanced automated claims processing system (eMedNY) as well as certain supporting automated systems. We examined CSC’s execution, and the Department’s oversight, of this contract.

We found that CSC had developed and implemented eMedNY and one of the supporting systems, but the implementation of both systems was significantly delayed, and as a result, $168 million in additional costs were incurred by the Department. The Department elected not to penalize CSC for the delays, even though such penalties were authorized by the contract. We recommended the Department reconsider its position on this matter. We also determined that, in some instances, contract payments to CSC were not supported by documentation indicating that the full payment amount was justified. CSC was also supposed to implement two automated systems that would facilitate the detection and prevention of fraud; however, both of these systems were behind schedule and neither system had been implemented. We recommended that certain improvements be made in the Department’s contract oversight practices.

For a complete copy of Report 2005-R-3 click here.
For a copy of the associated follow-up report click here.