Skip to main content
Report File
Date Issued
Submitting OIG
Department of Health & Human Services OIG
Other Participating OIGs
Department of Health & Human Services OIG
Agencies Reviewed/Investigated
Department of Health & Human Services
Report Number
A-02-18-01020
Report Description

A prior OIG audit found that New York made more than $7 million in unallowable Federal Medicaid payments to different managed care organizations (MCOs) for the same month for beneficiaries assigned more than one Medicaid identification (ID) number. A recent analysis of Medicaid data showed that New York continued to make these improper payments despite the improvements it made to its processes for identifying beneficiaries with multiple Medicaid ID numbers.

Report Type
Audit
Location

NY
United States

Number of Recommendations
3
Questioned Costs
$1,257,368
Additional Details
https://oig.hhs.gov/oas/reports/region2/21801020.asp
External Entity
State of New York

Open Recommendations

This report has 3 open recommendations.
Recommendation Number Significant Recommendation Recommended Questioned Costs Recommended Funds for Better Use Additional Details
268263 No $11,257,368 $0

We recommend that the New York State Department of Health refund $11,257,368 to the Federal Government

268264 No $0 $0

We recommend that the New York State Department of Health identify and recover improper managed care payments made to different MCOs on behalf of beneficiaries with multiple Medicaid ID numbers prior to and after our audit period, and repay the Federal share of the amounts recovered

268265 No $0 $0

We recommend that the New York State Department of Health strengthen its procedures for determining whether an individual applying for Medicaid has already been assigned a Medicaid ID number by ensuring that: - its system queries identify all individuals with existing Medicaid ID numbers and - local district and Marketplace staff follow guidance on identifying individuals with Medicaid ID numbers and use all available resources to identify and prevent the issuance of multiple Medicaid ID numbers to the same individual.

Department of Health & Human Services OIG

United States