ALBANY - New York state paid nearly $10 million in Medicaid claims over five years for home care and transportation services for patients who were either in the hospital or had died, according to an audit.
Comptroller Thomas DiNapoli blamed the state Department of Health for not detecting the overpayments, a problem also identified in past audits.
The comptroller's office reviewed records for a five-year period that ended in April 2006 and found the state paid $5.7 million for home care while Medicaid recipients were in the hospital or had died.
Most of those overpayments were for hospitalized patients. Roughly $14,000 was paid for the care of patients who had died.
A separate audit of medical transportation providers during the same period found about $4 million in payments for trips that probably never happened because the patients were already in the hospital.
The state paid just under $1 billion in Medicaid claims for home care and about $338 million for transportation in 2004, the most recent information available, according to the health department.
DiNapoli said the audit findings underscore a problem with the state's Medicaid claims processing system, which is administered by the health department.
Claire Pospisil, a health department spokeswoman, pointed out that the comptroller's audit covered Medicaid billing during former Gov. George Pataki's administration.
Since Gov. Eliot Spitzer took office in January, the agency has beeen upgrading the system to “stop and detect fraudulent billing and close the cracks,” Pospisil said, although she could not provide details.
In written responses in April, the health department questioned the comptroller's findings, saying that at least some of the data or its interpretation was flawed. The agency said the comptroller's report overstated the possible home care overpayments by more than $2 million.
The health department said it was already investigating $2.4 million in questionable home care claims when it received the comptroller's report in the spring. The agency said it is reviewing the $4 million in transportation payments the comptroller's audit identified.
AP-ES-08-28-07 1550EDT
The comptroller's office reviewed records for a five-year period that ended in April 2006 and found the state paid $5.7 million for home care while Medicaid recipients were in the hospital or had died.
Most of those overpayments were for hospitalized patients. Roughly $14,000 was paid for the care of patients who had died.
A separate audit of medical transportation providers during the same period found about $4 million in payments for trips that probably never happened because the patients were already in the hospital.
The state paid just under $1 billion in Medicaid claims for home care and about $338 million for transportation in 2004, the most recent information available, according to the health department.
DiNapoli said the audit findings underscore a problem with the state's Medicaid claims processing system, which is administered by the health department.
Claire Pospisil, a health department spokeswoman, pointed out that the comptroller's audit covered Medicaid billing during former Gov. George Pataki's administration.
Since Gov. Eliot Spitzer took office in January, the agency has beeen upgrading the system to “stop and detect fraudulent billing and close the cracks,” Pospisil said, although she could not provide details.
In written responses in April, the health department questioned the comptroller's findings, saying that at least some of the data or its interpretation was flawed. The agency said the comptroller's report overstated the possible home care overpayments by more than $2 million.
The health department said it was already investigating $2.4 million in questionable home care claims when it received the comptroller's report in the spring. The agency said it is reviewing the $4 million in transportation payments the comptroller's audit identified.
AP-ES-08-28-07 1550EDT
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