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Where To Report Waste Fraud, Abuse, Or Retaliation

New York Made Unallowable Payments Totaling More Than $10 Million for Managed Care Beneficiaries Assigned Multiple Medicaid Identification Numbers

Submitting OIG: 
Department of Health & Human Services OIG
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.
Date Issued: 
Thursday, February 20, 2020
Agency Reviewed / Investigated: 
Department of Health & Human Services
Submitting OIG-Specific Report Number: 
A-02-18-01020
Component, if applicable: 
Centers for Medicare & Medicaid Services
External entity, if applicable: 
State of New York
Location(s): 
NY
United States
Type of Report: 
Audit
Questioned Costs: 
$1,257,368
Number of Recommendations: 
3
View Document: 
AttachmentSize
PDF icon 21801020.pdf1.55 MB
Additional Details Link: 
https://oig.hhs.gov/oas/reports/region2/21801020.asp

Related Open Recommendations

Recommendation Number Recommendation Status Significant Recommendation Additional Details
268263 Open No
We recommend that the New York State Department of Health refund $11,257,368 to the Federal Government
268264 Open No
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 Open No
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.
Displaying 3 of 3 Recommendations