DiNapoli: State Recovered $46 Million in Nursing Home Over Payments
New York State was able to recover $46 million in over payments to nursing homes after an audit by State Comptroller Thomas DiNapoli found the Department of Health’s computer system failed to deduct payments some nursing home residents are required to pay for their care.
A new report by DiNapoli shows that deficiencies in the computer system still exist. Medicaid recipients with income from Social Security, pensions or other sources are required to pay for some of the cost of their nursing home care.
The amount they pay is known as net available monthly income, or NAMI. New York’s county social service offices and the Human Resources Administration in New York City are responsible for determining NAMI amounts for their Medicaid nursing home recipients.
The Office of the Medicaid Inspector General (OMIG) investigates and recovers improper Medicaid payments on behalf of DOH. With a consultant’s assistance, OMIG analyzed DiNapoli’s findings, and at the time of the follow-up, had recovered $30 million in over payments and expected to recover another $16 million in overpayments. Still, auditors found DOH had not implemented controls that would properly apply NAMI towards the cost of nursing home care going forward and urged DOH to do so.