Saturday, June 9, 2018

HHS OIG Busts New York, Again, For Medicaid Fraud - $74 Million

For those of you who are not familiar with the false claims in New York Medicaid fraud in child welfare, you will be.

Stay tuned.

New York is the international hub when it comes to privatization and other nefarious Public Private Partnerships in fraudulent billing for the purposes of pilfering the coffers of the Social Security Trust Fund.

For 27 of 120 sampled claims, New York claimed Federal reimbursement for CDPAP services claims that did not meet Medicaid requirements.
Specifically, New York did not provide documentation of services claimed, claimed reimbursement for services that were not authorized or supported, and claimed reimbursement for claims for which documentation was not completed in a timely manner.
New York also claimed reimbursement for services provided after a 6-month authorization period had lapsed. This occurred because New York did not effectively monitor the CDPAP for compliance with certain CDPAP requirements.
Based on our sample results, we estimated that New York improperly claimed at least $74.8 million in Federal Medicaid reimbursement during our audit period. New York’s lack of effective monitoring of the CDPAP leaves the program vulnerable to misuse of Federal funds and could potentially place beneficiaries at risk of harm.
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