NYS Medicaide Debacle

Friday, September 12, 2025 at 6:17 AM

Over a billion dollars in state Medicaid payments have been called into question by the Comptroller.

State Comptroller, Thomas DiNapoli, said a state audit found multiple issues with how out-of-state Medicaid members were identified. He said close to $1.2 billion in managed care premiums were paid for members who may not have lived in NY.  Auditors found that the Department of Health did not properly check to confirm that Medicaid members were New York residents.  In their response, DOH officials agreed to explore the use of other data sources to identify out-of-state members and engage with the federal government to better establish residency.

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