The New York State Comptroller's Office believes it has spotted an opportunity for the Department of Corrections and Community Supervision to save millions of dollars every year.
According a report released on Wednesday, state Comptroller Thomas P. DiNapoli said DOCCS could save up to $20 million annually by billing Medicaid, a health program for low-income individuals, for offenders receiving eligible inpatient care.
DiNapoli's claim comes after the Division of State Government Accountability audited two years of medical payments made by DOCCS to see if the department "paid health care providers the correct rate for only appropriate and authorized medical services."
After examining a sample of 430 clinical claims, DiNapoli said auditors found DOCCS did not always pay medical care providers correctly, resulting in $84,053 worth of over-payments. DiNapoli said providers were incorrectly billed due to double billing, upcoding and unbundling.
In a written response to auditors' suggestions, Carl J. Koenigsmann, deputy commissioner/chief medical officer for DOCCS, said the department partially agreed with the Comptroller Office's findings. As for the suggestion that DOCCS bill Medicaid for "eligible offender inpatient care," Koenigsmann said that was partially a moot point.
"While DOCCS has been doing this, we want to note that estimated savings is speculative, since we do not know the percentage of offenders who are eligible for Medicaid," Koenigsmann wrote.
Koenigsmann said DOCCS created a form to track clinic hours to ensure the department only paid health care providers for hours worked and agreed to review claims in order to avoid overpaying providers.
In the meantime, Koenigsmann said DOCCS would continue to seek reimbursement for the bills the department overpaid. So far, Koenigsmann reported DOCCS has collected $78,966.27 in overcharges.