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DiNapoli: New York May Be Paying Medicaid Premiums for People Living Out-of-State
NY State Comptroller ^ | 9/9/2025 | NY State Comptroller

Posted on 09/23/2025 11:39:03 AM PDT by God luvs America

An audit released today by State Comptroller Thomas P. DiNapoli found multiple issues with how the state identified out-of-state Medicaid members, and found close to $1.2 billion in managed care premiums that were paid for members who may have resided outside of New York. Auditors found that the state Department of Health (DOH) did not properly check to confirm that Medicaid members were New York residents and waited too long to recoup improper payments.

“Medicaid is a vital program and the single biggest expense in the state budget. We cannot afford any wasteful spending,” DiNapoli said. “If a person is enrolled in more than one state at the same time, both states may end up paying premiums to his or her managed care plans. Responsibility for preventing enrollment in more than one state lies at both the federal and state levels, and stronger coordination is needed to reduce improper payments, protect the program’s integrity, and ensure New York is only paying Medicaid costs for its residents.”

Medicaid members are enrolled through the New York State of Health (NYSOH) or through local departments of social services (Local Districts). Most of the state’s Medicaid members are enrolled in managed care plans, which are responsible for ensuring members have access to a range of health care services and reimbursing providers for those services. In exchange, DOH pays the plans a monthly premium for each enrolled member. Generally speaking, if a member who is enrolled in a managed care plan no longer resides in New York, they should be disenrolled from their plan and the plan must return premiums paid for periods when the member was not a resident. The audit examined the period from July 2017 through October 2024.

(Excerpt) Read more at osc.ny.gov ...


TOPICS: Business/Economy; Culture/Society; Government; News/Current Events
KEYWORDS: medicaid; newyork; nysoh; thomaspdinapoli; yousoundsurprised
Ironic- just a few months ago when DOGE identified this problem/corruption, liberals went ballistic claiming it didn't exist and people would "lose their medicaid"....yet now the Comptroller's office in blue state NY has in fact identified the same issue.
1 posted on 09/23/2025 11:39:03 AM PDT by God luvs America
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To: God luvs America

NY State, and especially NY City - live off the welfare, skimmings and taxes of others.

Remove funding from taxes on Wall Street and Fed.gov transfers, and NY State turns into the poorest state in the nation.


2 posted on 09/23/2025 11:41:59 AM PDT by PGR88
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To: God luvs America
Florida says "Thanks New York!!!"


3 posted on 09/23/2025 11:42:19 AM PDT by Magnum44 (...against all enemies, foreign and domestic... )
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To: God luvs America

“DiNapoli: New York May Be Paying Medicaid Premiums for People Living Out-of-State”

And probably many are not legal American citizens.


4 posted on 09/23/2025 11:49:08 AM PDT by antidemoncrat
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To: God luvs America

NY can’t afford this. They have to save those Medicaid dollars for treating illegal aliens.


5 posted on 09/23/2025 11:49:23 AM PDT by sphinx
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To: God luvs America

wait a minute. Didn’t Obama make healthcare free?


6 posted on 09/23/2025 11:57:54 AM PDT by ProudDeplorable (Concentrated power has always been the enemy of liberty. ~ Ronald Reagan)
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To: God luvs America

In Illinois and Wisconsin it is a fairly common practice for welfare cheats to be double dipping by going back and forth between Milwaukee and Chicago collecting from both.


7 posted on 09/23/2025 12:00:16 PM PDT by Biblebelter
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To: All

FTA-— The audit examined the period from July 2017 through October 2024.
<><>if a member who is enrolled in a managed care plan no longer resides in New York,
<><>they should be disenrolled from their plan
<><>and the plan must return premiums paid for periods when the member was not a resident.


8 posted on 09/23/2025 12:26:18 PM PDT by Liz (May you be in Heaven half an hour before the devil knows you're dead (Irish blessing))
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To: God luvs America

I thought using auditors was wrong! I mean, everybody knows that people like Miss James just has multiple primary houses for her all over the place and that’s OK!


9 posted on 09/23/2025 12:27:53 PM PDT by Lockbox (politicians, they all seemed like game show host to me.... Sting)
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To: Biblebelter

“In Illinois and Wisconsin it is a fairly common practice for welfare cheats to be double dipping by going back and forth between Milwaukee and Chicago collecting from both.“

Ah, the Kenosha trick.


10 posted on 09/23/2025 3:25:48 PM PDT by The Antiyuppie (When small men cast long shadows, it is near the end of the day)
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