Department of Health
Inappropriate Medicaid Payments for Recipients With Multiple Identification Numbers (Follow-Up)
Issued: August 13, 2012
Link to full audit report 2011-F-15
Purpose
To determine the extent of implementation of the four recommendations included in our initial audit report, Department of Health: Inappropriate Medicaid Payments for Recipients with Multiple Identification Numbers (Report 2008-S-163).
Background
Our initial audit report, which was issued on December 22, 2009, examined whether the Department ensured local districts properly assigned identification numbers to individuals eligible for Medicaid and if inappropriate Medicaid payments were made because Medicaid recipients were assigned multiple identification numbers. For the three years ended December 31, 2008, we identified over $53 million in improper Medicaid payments for recipients who had multiple identification numbers. These overpayments occurred primarily because local district officials assigned 25,950 Medicaid recipients more than one identification number, and the Department made separate Medicaid payments under each identification number. We identified several circumstances which led to the assignment of multiple Medicaid identification numbers to recipients. Our initial audit report contained recommendations for improving Department oversight and local districts’ effectiveness in preventing eligible Medicaid recipients from receiving more than one identification number. We also recommended the Department recover improper Medicaid payments. The objective of our follow-up was to assess the extent of implementation, as of June 30, 2012, of the four recommendations included in our initial report.
Key Findings
- Department officials made some progress in correcting the problems we identified in the initial report and recovered $1,680,000 in overpayments. However, further actions are still needed. All four of the prior audit’s recommendations were partially implemented.
Key Recommendations
- Officials are given 30 days after the issuance of the follow-up review to provide information on any actions that are planned to address the unresolved issues discussed in this review.
Other Related Audits/Reports of Interest
Department of Health: Inappropriate Medicaid Payments for Recipients with Multiple Identification Numbers Report 2008-S-163
State Government Accountability Contact Information:
Audit Director: Brian Mason
Phone: (518) 474-3271; Email: StateGovernmentAccountability@osc.state.ny.us
Address: Office of the State Comptroller; Division of State Government Accountability; 110 State Street, 11th Floor; Albany, NY 12236
