Institutional Federal Compliance Report 2021

STATE OF NEW YORK

Schedule of Findings and Questioned Costs

Year ended March 31, 2018

For 8 out of 52 weekly cycles, beneficiary claims paid through State’s Medicaid Management Information System (MMIS) were made to a total of 105,165. For 7 of the 105,165 paid during the period 8 weekly cycles selected, the providers were not listed on the listing of eligible providers as they were deemed terminated or inactive. These 7 providers claimed $37,799 during the 8 selected cycles. Cause The Department attributed the continuation of payments to the inactive or terminated providers to a delay in timing of processing the provider termination paperwork. The Department does not have a process in place to review claims paid under the Federal Medicaid program with a service date subsequent to a provider’s termination or inactive date. Possible Asserted Effect Failure to appropriately identify providers’ payments made subsequent to the termination of provider agreements resulted in ineligible providers receiving federal funds. Statistical Sampling The sample was not intended to be, and was not, a statistically valid sample. Repeat Finding A similar finding was included in the prior year Single Audit Report as finding number 2017-026 on pages 71 and 72. Questioned Costs $37,799 (total payments made to the 7 terminated or inactive providers during the 8 cycles reviewed) Recommendation We recommend that the Department revise its process and internal controls to ensure that the claims paid to providers that are inactive or terminated are reviewed to ensure any payment made subsequent to their termination or inactive date are recouped by the Department. Views of Responsible Officials The Department agrees with the recommendation. Please see corrective action plan for further details.

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