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NY officials crackdown on Medicaid overpayments: 3 things to know

On Behalf of | Aug 29, 2023 | Medicare Overpayment |

Physicians and other healthcare providers are wise to take note of the high likelihood of a crackdown on Medicaid overpayments in New York. A more aggressive approach towards recouping funds is likely after the release of a follow-up report on a New York State Comptroller audit that found New York’s Department of Health had failed to recover millions in overpayments.

#1: The NY Department of Health is feeling pressure to deliver.

The Office of the New York State Comptroller called out the state’s Department of Health for failing to recover these overpayments. The agency gave the department a list of things to change to better ensure payments are appropriate and provided tips on how to recoup these funds in the initial report. The more recent follow-up includes a call for the department to report back on plans to address the issue within 30 days.

The agency has made it clear it expects progress when it comes to recovering these funds.

As if pressure from the state comptroller was not enough, some media outlets have also caught wind of the audit and are reporting on the issue as an example of poorly used funds from taxpayers. This could trigger public outrage and further encourage the department to pursue more aggressive methods to recover the funds.

#2: Pressure could result in false claims of overpayment.

Those under pressure to perform and the focus of negative scrutiny are more likely to make mistakes. This is true of anyone — from the Average Joe to the Brilliant Surgeon to the Government Official. If you believe that the government made a mistake when they sent your practice or group a demand for an overpayment, you may be right.

#3: You have options.

Those who receive notification of an overpayment have options. You can appeal the demand for repayment. The process involves different levels and can be complex. It is wise to seek legal counsel to help guide you through the process and better ensure a favorable outcome.

Attorney John Rivas is responsible for this communication.

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