
New York State lost $100 million over a four year period because the State Department of Health’s (DOH) eMedNY Medicaid reimbursement system failed to properly apply a 20 percent coinsurance limit on certain charges, and the eMedNY system lacked controls to detect incorrect claims information about Medicare payments, according to an audit released by State Comptroller Thomas P. DiNapoli. The audit was among three DiNapoli released on Medicaid waste Monday.
“We keep ringing the same bell, but DOH just doesn’t hear it,” DiNapoli said. “Time and time again, our audits have found overpayments, double payments, and fraudulent payments. Taxpayers can’t afford this. Now more than ever, every dime counts, and $100 million is a lot of taxpayer dimes. DOH has to do a better job of protecting the taxpayers’ money.”