Department of Health

Collections of Medicaid Accounts Receivable

The Department of Health administers New York Stateís Medicaid program, which provides medical assistance to eligible individuals. The Departmentís administration of the program includes recovering accounts receivable arising when medical service providers are overpaid for their services. The Department identifies such overpayments through provider audits performed by the New York State Office of the Medicaid Inspector General or when reimbursement rates are adjusted retroactively.

During calendar years 2008 and 2009, the Department identified $1.1 billion in new accounts receivable for active providers. As of January 26, 2010, the Department had collected about $990 million (90 percent) of this receivable amount. Consequently, we concluded that the Department did an effective job of recovering accounts receivable from active providers. However, we also found that the Department needed to improve its collection efforts in certain special situations pertaining to inactive providers, providers who join group practices, and providers who are affiliated and share the same federal taxpayer identification number. In addition, we noted that the Department needed to act in a timely manner to submit uncollected accounts receivable to the State Attorney General for follow up. In total, we found the Department needed to act more effectively to collect about $37 million in such accounts receivables.

For a complete copy of Report 2009-S-59 click here.