Audits published by New York State's Comptroller Thomas P. DiNapoli
Issued during the week ending March 29, 2013 [Click on the caption to access the full report]
Department of Health, Medicaid Claims Submitted by Accordis Inc. on Behalf of HHC (2011-S-29)
Healthcare providers submit Medicaid claims to the Department of Health’s eMedNY claims processing system for payment of their services. For various reasons, eMedNY denies payment of many claims. Claims that are denied can be modified and resubmitted to eMedNY for payment. In March 2005, HHC hired Accordis to provide billing services for HHC-affiliated providers. For the three-year period ended Dec. 31, 2010, Accordis submitted 192,296 claims totaling more than $26.2 million on behalf of HHC providers. Auditors found eMedNY does not provide a mechanism for associating a paid claim to its previously denied claim. As a result, auditors could not determine whether changes made by Accordis to previously denied claims were appropriate.
Department of Health, Medicaid Claims Submitted by Accordis Inc. on Behalf of HHC (2011-S-29)
Healthcare providers submit Medicaid claims to the Department of Health’s eMedNY claims processing system for payment of their services. For various reasons, eMedNY denies payment of many claims. Claims that are denied can be modified and resubmitted to eMedNY for payment. In March 2005, HHC hired Accordis to provide billing services for HHC-affiliated providers. For the three-year period ended Dec. 31, 2010, Accordis submitted 192,296 claims totaling more than $26.2 million on behalf of HHC providers. Auditors found eMedNY does not provide a mechanism for associating a paid claim to its previously denied claim. As a result, auditors could not determine whether changes made by Accordis to previously denied claims were appropriate.
Department of Health, Medicaid Overpayments for Non-Emergency Out-of-State Inpatient Services (Follow-Up) (2012-F-25)
In an initial report, auditors found that for the period May 1, 2002 through April 30, 2009, Medicaid made potential overpayments totaling $9.2 million to out-of-state hospitals. Auditors further identified $10.8 million in claim payments for which DOH had not granted the required prior approvals. In a follow up report, auditors found DOH made progress in addressing those issues.
Office of the Attorney General, Accounts Receivable Collections (2011-S-25)
Auditors determined OAG’s Civil Recoveries Bureau was generally effective in its collection of accounts receivable referred by state agencies. Auditors recommended the bureau enhance its collection actions through computer matches with state and New York City payrolls to locate debtors.
As part of a statewide initiative to determine whether the use of travel money by selected government employees was appropriate, auditors looked at travel expenses for the highest-cost travelers in the state for the following state entities:
State University of New York, The College of Fredonia - Selected Employee Travel Expenses (2012-S-138)
Two of these employees worked at the College at Fredonia and had travel costs totaling $689,762. Auditors also examined other travel expenses including three employees with outliers in air and train fares that totaled $148,505. The travel expenses for the five employees were documented and adhered to state travel rules and regulations.
State University of New York, College at Geneseo - Selected Employee Travel Expenses (2012-S-139)
Three of these employees worked at SUNY Geneseo and had travel costs totaling $252,042. The travel expenses for the three college employees selected for audit were documented and adhered to state travel rules and regulations.
State University of New York, Institute of Technology at Utica/Rome - Selected Employee Travel Expenses (2012-S-146)
One of these employees worked at the State University of New York Institute of Technology (SUNYIT) and had travel costs totaling $101,605. Auditors found that the travel expenses for the SUNYIT employee selected for audit were documented and adhered to state travel rules and regulations.
State University of New York, College at Brockport - Selected Employee Travel Expenses (2012-S-150)
One of these employees worked at the College at Brockport (college) and had travel expenses totaling $143,258. Auditors found that the employee’s travel expenses were documented and adhered to state travel rules and regulations.