State DOH Wasted Millions, Says DiNapoli

The New York State Department of Health wasted tens of millions of dollars on overpayments to nursing homes through Medicaid, according to an audit from the Office of the New York State Comptroller.

The audit, which examined state DOH Medicaid expenditures over 44 months, found that the state overpaid nursing homes by at least $42 million due to the fact that many care providers do not, as required, collect money from their clients and that, furthermore, local governments do not enforce the requirement. Overall, Medicaid pays about $6.8 billion for nursing home care for about 121,000 people a year, of which the federal government provides half; the state government provides 40 percent and local governments pay the remainder.

State Comptroller Thomas P. DiNapoli said he believes it is likely the overpayment could even be much higher than estimated. A legacy computer system predating the 2005 introduction of eMedNY -- which processes nursing home provider claims for Medicaid reimbursement -- was itself previously found to have been improperly processing required offsets.