New York’s Medicaid audits too punitive, groups say

Healthcare providers in New York want more due process protections when they are audited by the state’s Office of the Medicaid Inspector General, Spectrum News 1 reported Aug. 18.

Dozens of healthcare and advocacy groups accused the office of using tactics that “fail to take a transparent or fair and balanced approach to the audit and recovery process,” according to the report.

The groups said many of the audits have resulted in large fines that were often the result of clerical errors, according to the report. They cited one example of a provider getting fined $7.7 million for clerical errors worth $400, without any evidence of fraud or abuse.

“As a result, providers who have operated in good faith and delivered high-quality care to clients, but who may have made human errors in the process, have been punished as if they had intentionally and maliciously defrauded the state,” a letter sent to Gov. Kathy Hochul stated, according to the report.

A proposed state senate bill would require the Medicaid inspector general to notify a provider if the compliance program is not doing enough and allow for a two-month window to make changes, according to the report.

Source: New York’s Medicaid audits too punitive, groups say / Becker’s Payer Issues

Leave a Reply

Your email address will not be published.