Medicaid has overpaid by $77 million-- $46 million on nursing homes and $31 million on inpatient hospital care bills, respectively-- from 2006 to 2012.
The New York state auditors publicized the report this week blaming the overpayment to the computer system being used by the Department of Health. The computer system missed to remove a portion of the patient's pensions, Social Security, and other sources of income from the medical bills. The health department also introduced a new billing system that seemed to benefit the hospitals, WSJ reports.
State Comptroller Thomas DiNapoli told WSJ he was disappointed with this incident as the inaccurate charges should have been detected immediately by the health department. It could have saved the government $77 million budget and had it allocated to other programs which need funding instead. The nursing homes were overpaid from 2006 to 2010 while the hospitals has received the overpayment from 2009 to 2012. The auditors reviewed only 1,833 in-patient claims to compute the overpayment.
Meanwhile, the state health department has responded that their budget had remained the same for two years, ending a 13 percent yearly growth, yet they were able to expand Medicaid to 500,000 residents affected by the recession and cost-cutting of various companies.
New York Medicaid has received $54 billion as budget for 2013 for 5.3 million residents enrolled in the program.
Medicaid has confirmed with WSJ that the nursing homes have already returned $30 million of the excess payments while the excess for the in-patient bills is most likely to happen after Dec. 1 once they have finalized the new billing system.
The N.Y State health department spokesperson Bill Schwarz commented on DiNapoli's report in WSJ as inaccurate as it failed to consider that the in-patient billing system already reduced the costs by $220 million each year. He also noted that $31 million, or the 0.3 percent error rate, isn't that significant compared to the $10 billion expenses under Medicaid.
