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Billing error leads to $1.5B in improper NY Medicaid payments

Rolled up paper bills

The New York Department of Health paid out more than $1.5 billion in improper Medicaid payments due to a billing system error.

Reports by State Comptroller Thomas DiNapoli found a number of claims were paid without an appropriate National Provider Identifier. That number ensures the provider is properly qualified.

DiNapoli said the e-Med-NY system that processes Medicaid claims is to blame. State auditors found $57 million dollars in payments for pharmacy claims that did not contain an appropriate prescriber number. Another $19 million was paid for claims that should not be included on Medicaid.

The state’s Medicaid claim costs totaled about $70 billion last year.