New York improperly billed Medicaid $84.3M, OIG says

An audit from the HHS Office of the Inspector General found that New York improperly billed Medicaid at least $84.3 million for nonemergency medical transportation services provided in New York City. 

The office's audit covered more than 4.7 million payments totaling more than $269.5 million for nonemergency medical transportation services in 2018 and 2019, according to the report. The office selected a stratified random sample of 100 payments for review. It reviewed documentation maintained by the contractor hired by the state to manage the program, as well as documentation from medical and transportation service providers. 

The audit found that 17 of the 100 sampled payments complied with federal and state requirements and 41 did not comply, according to the report. In 42 instances, auditors could not determine whether the services complied with requirements. 

On the basis of the sample results, the office estimated that New York improperly claimed at least $84.3 million in federal Medicaid reimbursements. It also estimated the state claimed $112 million in federal reimbursement that may not have complied with certain federal and state requirements. 

The office recommended the state refund $84.3 million and review the $112 million in reimbursement that may not have met requirements, according to the report. 

Read the full report here

Copyright © 2022 Becker's Healthcare. All Rights Reserved. Privacy Policy. Cookie Policy. Linking and Reprinting Policy.

 

Featured Whitepapers

Featured Webinars