Selected reports issued by the Office of the State Comptroller during the week ending August 13, 2016
Office of Temporary and Disability Assistance: National Directory of New Hires Data Security
Queens County District Attorney’s Office - Oversight of Persons Convicted of Driving While Intoxicated
Although 9,604 offenders overseen by the office received court orders to install Ignition Interlock Devices (IIDs), only 1,952 offenders (20.3 percent) did. By borough, IID installation rates ranged from 9 percent in Brooklyn to 30 percent in Staten Island. Generally, offenders who did not install IIDs signed court affidavits stating that they would not drive a motor vehicle during the period of conditional discharge unless it had an IID. Auditors also found material noncompliance with the office’s protocols to minimize the risk that offenders would drive vehicles without IIDs.
State Education Department (SED): Early Education Center, Compliance with the Reimbursable Cost Manual (2015-S-96)
NYS Department of Education - The Alcott School; Compliance With the Reimbursable Cost Manual
For the year ended June 30, 2014, auditors identified $55,969 in ineligible costs that Alcott reported on its CFR. The ineligible costs included: $52,442 in personal service costs, which consisted of $49,874 in unsupported staff time, and $2,568 in employee compensation that was reported as more than one full-time equivalent on the CFR; and $3,527 in other than personal service costs, which consisted of $1,889 in inadequately documented expenses, $1,252 in working capital interest, and $386 in food and other non-reimbursable costs.
State Education Department: The Alcott School, Compliance with the Reimbursable Cost Manual (2015-S-97)
Metropolitan College of New York; Higher Education Services Corporation; State Education Department - Audit of the State Financial Aid Program at Metropolitan College of New York, Report 2015-T-7
Auditors determined that the procedures used by Metropolitan officials to certify students for state financial aid substantially complied with the governing law and regulations. However, Metropolitan was overpaid $20,944 because school officials incorrectly certified some students as eligible for financial aid.
Inappropriate Medicaid Payments
New York state’s Medicaid system made as much as $12.1 million in inappropriate payments during 2015, including $2.3 million for dead patients and millions more for recipients who had been dropped from long term care coverage, according to an audit released August 9, 2016 by State Comptroller Thomas P. DiNapoli. By the end of audit fieldwork, about $2.1 million of the overpayments were recovered.
The Comptroller said: “My auditors continue to find glitches in the Department of Health’s payment control systems that allow wasteful payments to be made,” DiNapoli said. “The department agreed with most of our recommendations and is working to fix the problems we have uncovered. It should recover up to $10 million that should not have been spent.”
New York’s Medicaid program, administered by the state Department of Health (DOH), is a federal, state, and locally funded program that provides a wide range of medical services to those who are economically disadvantaged or have special health care needs.
DOH’s eMedNY computer system processes Medicaid claims submitted by providers for services rendered to Medicaid-eligible recipients and generates payments to reimburse the providers for their claims.
DiNapoli’s office audits Medicaid payments on a routine basis to make sure claims are being paid appropriately and to determine if improvements are needed and whether money should be recovered because of errors, abuse or fraud. In 2015, DiNapoli’s auditors questioned $223 million in payments.
Managed Long-Term Care (MLTC) plans provide services to recipients who have a long-lasting health problem or disability. Medicaid pays MLTC plans a monthly payment for every recipient enrolled in an MLTC plan. According to the department’s MLTC contract, DOH has the right to recover capitation payments made to plans for recipients who it is later determined were inappropriately enrolled because of death, incarceration, or relocation out of the plan’s service area. From Feb. 1, 2015 to Sept. 30, 2015, Medicaid made 1,745 capitation payments totaling more than $7.1 million for 1,324 recipients who were retroactively disenrolled from a plan by DOH or local Departments of Social Services.
With the enactment of the federal Patient Protection and Affordable Care Act (PPACA) in 2010, the state developed New York State of Health (NYSOH) as a new online marketplace for individuals to obtain health insurance coverage, including Medicaid. The PPACA requires NYSOH to verify an applicant’s identifying information when determining Medicaid eligibility and enrollment. Once individuals are enrolled in Medicaid, NYSOH is required to periodically verify recipients are alive to ensure active coverage is appropriate.
DiNapoli’s auditors determined NYSOH enrolled 119 deceased individuals into the Medicaid program, and NYSOH did not automatically terminate 1,177 enrollees who apparently died after enrollment. Medicaid overpaid 4,892 claims totaling $2,282,626 on behalf of 966 enrolled recipients. At the end of our fieldwork, 766 of the 1,296 deceased enrollees still had active Medicaid coverage through NYSOH.
DOH subsequently completed its review of the 766 enrollees, concluded that 4 individuals were alive and took the necessary steps to close the accounts of the remaining 762 enrollees.
DiNapoli’s auditors also found:
DiNapoli made 11 recommendations to DOH to recover the remaining inappropriate Medicaid payments and improve claims processing controls.
DOH generally agreed with the audit recommendations and indicated that certain actions have been and will be taken to address them. The agency’s complete response is included in the final audit.
Read the report or go to: http://www.osc.state.ny.us/audits/allaudits/093016/15s16.pdf