Department of Health

Medicaid Claims Processing Activity

New York State’s Medicaid program is administered by the Department of Health. Medicaid claims are processed and paid by an automated system that is operated by a contractor. On March 24, 2005, a new automated system (eMedNY) became operational. We examined selected claims processed by this system during the six months ended September 30, 2005. We identified overpayments totaling nearly $2.3 million. For example, one dental clinic was overpaid $1.8 million because system controls had not been established to prevent duplicate payments for orthodontic services. We recommended that the Department investigate, and if appropriate, recover the overpayments.

For a complete copy of Report 2005-S-31 click here.
For a copy of the associated follow-up report click here.