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NYS Comptroller

THOMAS P. DiNAPOLI

Taxpayers' Guide to State and Local Audits

Department of Health
Improper Managed Care Payments for Certain Medicaid Recipients (Follow-Up)


Issued: January 20, 2015
Link to full audit report 2014-F-7
Link to 30-day reponse

Purpose
To determine the extent of implementation of the five recommendations made in our audit report, Improper Managed Care Payments for Certain Medicaid Recipients (Report 2010-S-66).

Background
Our initial audit report, which was issued on July 24, 2012, determined that, for the five years ended June 30, 2010, Medicaid made $15.6 million in improper managed care payments on behalf of 14,899 recipients who, by State law, were precluded from enrollment in managed care programs. We recommended that the Department investigate the $15.6 million in improper Medicaid managed care payments and strengthen efforts to oversee and monitor Medicaid managed care enrollments.

Key Finding

  • Department officials made progress in addressing the problems we identified in our initial audit report. This included the recovery of $6.4 million in improper Medicaid managed care payments. However, further actions are still needed. Of the initial report’s five recommendations, two were implemented, two were partially implemented, and one was not implemented.

Key Recommendation

  • Officials are given 30 days after the issuance of the follow-up report to provide information on any actions that are planned to address the unresolved issues discussed in this report.

Other Related Audit/Report of Interest

Department of Health: Improper Managed Care Payments for Certain Medicaid Recipients 2010-S-66


State Government Accountability Contact Information:
Audit Director: Andrea Inman
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