New York Medicaid audit finds $965M in billing errors

New York's Medicaid program erroneously paid out $965 million in claims over four years, state comptroller Thomas DiNapoli said April 19. 

The audit from Mr. DiNapoli's office looked at claims made from January 2015 to December 2019, according to a news release from the comptroller. Auditors found the state's Medicaid claims-processing system allowed improper payments for services involving ordering, prescribing, referring and attending providers who were no longer actively enrolled in the Medicaid program at the time of the service. 

The improper payments included $5.8 million for services involving providers who were excluded from participating in Medicaid because of  past improper behavior or wrongdoing, according to a news release from Mr. DiNapoli's office. 

New York's health department made changes to the Medicaid program in February 2018, which led to a significant drop in the amount of improper payments, according to the news release. But auditors still identified about $45.6 million in claims payments for more than 135,000 services by ineligible providers.

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