Health Insurance Plans To Reimburse New York Medicaid Program $7M in Duplicate Billing

Armen Hareyan's picture

The Office of the New York State Attorney General on Monday announced that Healthfirst PHSPand St. Barnabas Community Health Plan have agreed to return to thestate a combined $7 million received as a result of duplicate billingsfor Medicaid and Family Health Plus beneficiaries, the New York Timesreports. A 2004 comptroller's audit of the state Medicaid program foundthat between July 2000 and November 2006, many beneficiaries mistakenlyhad been assigned multiple identification numbers by programadministrators. Further investigation showed that when multipleidentification numbers were entered into computer systems, multiplebills often were paid for a single claim.


According to stateAttorney General Andrew Cuomo (D), the error has been "costing New Yorkstate taxpayers millions of dollars." Under the settlement announced onMonday, Healthfirst will repay $6 million to the state, and St.Barnabas, which stopped operations last year, will repay $902,000.Cuomo said the companies are responsible for making sure such mistakesdo not occur.

However, Claudia Hutton, a spokesperson for the New York State Department of Health, said the companies did not do anything wrong because they "worked off information they got from the government."

Stateattorney general's office officials said the settlement is the first ina series expected in the coming months and estimated that the statecould recoup more than $30 million. Cuomo said the attorney general'soffice and the state inspector general were working with local socialservice agencies, which often assign identification numbers, and thestate health department to prevent multiple billings in the future(Sullivan, New York Times, 8/7).

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