CMS Issues Audit Report Seeking $1.26 Billion Repayment from New York's Medicaid Program

The Centers for Medicare and Medicaid Services (CMS) have released an audit report detailing a demand for repayment of $1.26 billion in federal Medicaid funds from New York State.  The findings arose out of a review of payments made under a new reimbursement methodology, implemented in 2013, for New York's developmental centers (state-operated intermediate care facilities for people with developmental disabilities).  The new methodology was implemented in response to overpayment findings in a 2012 OIG audit report. 

The latest review found that the reported costs for fiscal year 2010-11 were not adequately supported and that payments exceeded the federal upper payment limit by $1,257,499,670.  CMS is seeking a refund of this amount. The state has indicated that it will appeal CMS's determination.

Contact: Karen Lipson, klipson@leadingageny.org, 518-867-8383