Department of Health

Medicaid Claims Processing Activity: April 1, 2010 through September 30, 2010

Medicaid claims are processed and paid by an automated system (eMedNY) that is overseen by the Department of Health. We performed audit work related to the system and the payments made for the period April 1, 2010 through September 30, 2010. We concluded that eMedNY reasonably ensured that Medicaid claims were submitted by approved providers, were processed in accordance with requirements, and resulted in correct payments to the providers. However, we also identified certain conditions relating to actual and potential overpayments totaling almost $2.9 million, of which $2.3 million has already been recovered.

For a complete copy of Report 2010-S-15 click here.