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Report: NYS Routinely Overpays Hospitals

Tuesday, May 04, 2010

A new report suggests New York routinely overpays hospitals for various medical procedures. State Comptroller Thomas DiNapoli's office looked at how much the state Health Department and the Medicaid system pay when hospitals release and then re-admit patients.

DiNapoli says New York should emulate New Jersey, where hospitals don’t get paid for re-admitting patients within a week of discharge, unless they can justify the claim.

DINAPOLI: The Department of Health really needs to tighten up the ways in which claims are reviewed and processed.

REPORTER: DiNapoli estimates New York could have avoided $150 million worth of claims, if it challenged the bills hospitals submitted.

The Health Department, which administers the state’s Medicaid program, says improved computers and greater manual oversight will catch over-billing more often.

The audit also found that when New York picks up the Medicaid tab for its residents getting treated out-of-state, the Health Department regularly pays hospitals more than it would for the same procedure performed here.

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