The New York state Department of Health could save hundreds of millions of dollars if it had better oversight of enrollment in Medicaid and other public health plans, according to two audits released Thursday by state Comptroller Tom DiNapoli.
His office said audits found thousands of instances where state Medicaid paid costs that another federally funded health care plan like the Essential Plan, New York’s basic health plan, or Medicare should have paid.
The audits found state Medicaid could have saved up to $294.4 million in payments on medical services if 13,318 individuals who appeared qualified for Medicare had enrolled between July 2016 and June 2021.
“Far too often the Department of Health has let the state’s Medicaid program pay for services that federally funded health care programs should have covered,” DiNapoli said. “As the DOH continues its efforts to ensure everyone gets the health coverage they’re entitled to, it has a chance to save hundreds of millions of dollars by improving its oversight.”
The audits recommended the DOH ensure Medicare-eligible members are identified and enrolled and that it recover as much of the $93.7 million that should have been billed to the Essential Plan as it can.
Source : Spectrum