Department of Health

Medicaid Payments for Diabetic Testing Supplies

Diabetic individuals use certain items to monitor their blood glucose levels. In New York State’s Medicaid program, pharmacies may be reimbursed for providing these items to diabetic Medicaid recipients. The reimbursements received on behalf on any single individual should be limited to a certain number of the items per month. We compared the limits in New York’s Medicaid program to the limits in Medicare and ten other states’ Medicaid programs. We found that New York’s Medicaid program allows reimbursements for far more items per month than all the other programs. We determined that, if New York had used the same limits as Medicare, its Medicaid program could have saved nearly $13.8 million during the five year-period we examined.

We recommended the Department of Health consider lowering New York’s Medicaid limits on diabetic testing supplies. We also recommended the Department investigate certain instances we identified, in which it appeared that reimbursements had been claimed for an excessive number of testing supplies per recipient.

For a complete copy of Report 2008-S-123 click here.
For a copy of the associated follow-up report click here.