State Comptroller Recovers 46 Million Dollars for New York State

An audit of the Department of Health has recovered 46 million dollars in overpayments to nursing homes back to New York State.  State Comptroller Thomas DiNapoli found the DOH computer system failed to deduct payments some nursing home residents are required to pay for their care. 

In a statement DiNapoli said, “Over and over again, my auditors are finding poor oversight of payments and other big problems that have led to tens of millions of dollars of waste in the Medicaid program each year". 

The Office of the Medicaid Inspector General investigates and recovers improper Medicaid payments on behalf of DOH. With a consultant’s assistance, OMIG analyzed DiNapoli’s findings, and at the time of the follow-up, had recovered $30 million in overpayments and expected to recover another $16 million in overpayments. 

DiNapoli also notes some deficiencies in the computer system still exist.

 

DiNapoli’s auditors recommended DOH:

  • Develop controls to properly apply residents’ NAMIs towards the cost of their nursing home care;
  • Enhance Department oversight of localities through such techniques as data analysis to identify and assist those that may not be posting NAMI timely to eMedNY;
  • Advise localities to review resident’s NAMI at time intervals sufficient enough to avoid overpayments that cannot be recovered; and
  • Recover any overpayments.
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