Sneak Preview: N.Y. Aims To Limit Multiple Medicaid ID Numbers

September 7, 2012 | By Jerry Ashworth | Post a Comment

(The following was excerpted from an article in the Single Audit Information Service.) New York health officials are taking steps to limit the issuance of multiple Medicaid identification numbers in response to a New York Office of State Comptroller’s (OSC) audit that found that the state overpaid about $17.3 million in Medicaid benefit payments resulting from recipients enrolled with multiple IDs.

The New York Department of Health administers the state Medicaid program, which provides medical assistance to about 5 million individuals. To receive benefits, these individuals must apply at their local district, which assigns eligible Medicaid recipients unique ID numbers. This ID number is used across all public and medical assistance programs to control the delivery of benefits and the payments to benefit providers. Each recipient’s eligibility information and ID number is maintained by the state’s Welfare Management System (WMS).

After auditing the state Medicaid program from 2008 to 2010, OSC found that some 9,848 recipients had more than one Medicaid ID number, many of whom received multiple numbers from the New York City Human Resources Administration (HRA). Some $13 million in duplicate Medicaid payments were paid to 5,100 managed care plans using one ID number per recipient, and to hospitals and clinics under other ID numbers for the same recipient. In addition, about $2.6 million in duplicate payments were made to different managed care plans for the same recipient and $1.7 million in duplicate payments were made to the same managed care plan for the same recipient using different ID numbers.

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