Summary
New York State's audit discovered it possibly overpaid $2.7 billion in Medicaid managed care premiums for people who may have moved out of the state. The audit revealed issues in identifying out-of-state Medicaid members, with some already corrected by the New York Department of Health. This comes amid increased attention on Medicaid spending and efficiency.
Key Facts
- New York State's audit found a potential overpayment of $2.7 billion in Medicaid premiums.
- The audit was conducted by the State Comptroller's Office, led by Thomas P. DiNapoli.
- The audit highlighted problems in tracking Medicaid members living outside New York.
- Some issues have been fixed by the New York Department of Health during the audit.
- The Department did not use the PARIS data system for out-of-state checks until 2017, three years late.
- From 2017 to 2019, $1.5 billion in premiums was paid without verifying member residency.
- Florida, New Jersey, and Pennsylvania accounted for 35% of these out-of-state member payments.
- The focus on Medicaid efficiency has been a national issue since President Donald Trump's administration.
