OIG recommends NY refunds for invalid family planning Medicaid claims
Healthcare Auditing Weekly, June 10, 2008
The Office of Inspector General (OIG) concluded New York State received $918,816 in erroneous federal Medicaid funds for its Family Planning Benefit Program (FPBP). The OIG examined 147 of New York’s FPBP claims and found 37 were not eligible for federal reimbursement. Click here to read the full OIG report.
The overpayment occurred because, prior to May 2003, the state’s Medicaid Management Information System did not identify FPBP claims that were not relevant to family planning. Also, some providers incorrectly claimed services as family planning and some did not properly complete the Medicaid sterilization consent form.
The OIG recommends New York:
- Refund the federal government $918,816
- Remind providers that the FPBP is only for services directly related to family planning
- Remind providers a properly completed sterilization consent form must be prepared and maintained for all Medicaid sterilizations
- Determine how much federal Medicaid improperly paid to the state for FPBP claims prior to the OIG’s audit and refund those payments
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