Corporate Compliance

New York Medicaid fraud recoveries top $550M

Compliance Monitor, December 17, 2008

New York state recovered $551 million in Medicaid fraud and abuse for fiscal year (FY) 2009, according to a New York State Office of the Medicaid Inspector General (OMIG) press release. The $551 million total is more than double the $215 million goal set by Federal-State Health Reform Partnership (F-SHRP) prior to FY2009.
In a related story, New York state comptroller Thomas P. DiNapoli released an audit criticizing the state’s use of an automated Medicaid claims processing system, eMedNY.  According to a press release from DiNapoli, the eMedNY system is not being used properly and, as a result, inadequate oversight lead to millions of dollars in improper payments.
According to the press release, the New York Medicaid program made $1.8 million in overpayments to providers that incorrectly billed for Medicare Part B services. In 2007 auditors found $55 million in improper payments due to automated edits.


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