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April 11, 2012


Comptroller DiNapoli Releases Audits

New York State Comptroller Thomas P. DiNapoli announced today the following audits have been issued:

Department of Health, Overpayments to Cabrini Medical Center (2011-S-8)
The Gaeta Company caused $1.9 million in Medicaid overpayments to Cabrini Medical Center by incorrectly altering information on prior claims and resubmitting them to Medicaid. In these instances, the original claim was correct and should not have been adjusted and resubmitted.  Auditors also referred $618,000 in potential overpayments to the Department of Health for further review. In some cases, the adjustment claim was significantly more than the original claim. On one particular claim, Medicaid originally paid Cabrini $6,656. Gaeta, however, improperly adjusted the claim by omitting the amount Medicare already paid on it.  As a result, Medicaid overpaid the adjusted claim by $355,859. The eMedNY system did not have the controls necessary to identify unreasonable or suspicious adjustment claims.

Office of Children and Family Services, Youth Facility Chargeback Rates to Localities (2009-S-20)
OCFS is responsible for all elements of the state's juvenile justice program including the administration and management of various facilities housing juvenile offenders. Localities are required to reimburse OCFS for 50 percent of the expenditures incurred for the care, maintenance, and supervision of the youth within these juvenile facilities. OCFS' Rate Setting Unit develops the "chargeback" rates used to bill localities. Auditors found that OCFS calculates juvenile facility chargeback rates correctly. However, in general, OCFS has been deficient in revising its rates in a timely manner, as well as in billing and collecting millions of dollars in required reimbursements from localities. As of August 2010, OCFS officials have yet to collect at least $40 million.



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