Department of Health

Medicaid Claims Processing Accuracy (Follow-Up Review)

The State Comptroller maintains audit staff on site at the Department of Health to conduct continuous audits of the Department's automated system for making Medicaid payments, including weekly examinations of the accuracy of the Medicaid claims that are processed. During the year ended March 31, 1997, these weekly examinations found that health care providers were overpaid as much as $18.2 million. In our prior report 96-D-8, we recommended that these overpayments be recovered. In our follow-up review, we found that $3.1 million in overpayments have yet to be recovered. We also found that the Department has yet to correct the inappropriate Medicaid billing practices of two New York City hospitals, as we previously recommended.

For a complete copy of Report 99-F-6 click here.
For a copy of the 90-day response click here.