Audit: New York enrolled the dead in Medicaid, gave them government-funded health coverage

ALBANY, N.Y. – Flaws in New York’s health exchange resulted in 21 dead people being enrolled in Medicaid and 333 getting continuing government-funded health coverage after they died, according to audit results released Thursday.

The state comptroller’s office reported that its auditors found overpayments of $3.4 million for the year starting Oct. 1, 2013, when the exchange began operating. That included $325,000 in coverage for the deceased.

“Only by chance does New York State Of Health receive notification of the death of an enrolled recipient and begin the process to end Medicaid coverage,” the report said.

Auditors faulted “a range of design and process flaws” in the health exchange’s process for checking eligibility. The exchange was established by the state under the federal Affordable Care Act to provide commercial health insurance or Medicaid to the state’s uninsured, enrolling more than 2.1 million people.

The auditors said the state also issued multiple identification numbers to several thousand adults, children, newborns and even some unborn children who enrolled, resulting in Medicaid overpayments of $2.8 million.

The health department established the exchange and runs it. It disputed several audit findings in a written response.

Officials said the Social Security database was initially used to check for deaths and the department has been awaiting a new federal service for further verification. Last year, they implemented a manual process to link and eliminate payments under duplicate identification numbers.

Health officials also said they confirmed that 321 people cited in the audit were dead but said that four are still alive. They’re still checking on the other 29.

New York’s Medicaid enforcement efforts in 2011 through 2013 recovered $1.73 billion, they said. Meanwhile the state has cut spending growth to 1.7 per cent annually.

Medicaid covers about 6 million low-income New Yorkers and costs about $60 million annually. It’s paid almost half by the federal government, one-third by the state and the rest by counties and New York City.


This story has been corrected to show that the Medicaid enforcement recoveries of $1.73 billion were for the years 2011-2013, not 2011-2012.