WCDO Radio News

The State Assembly Task Force on the Heroin crisis held their 6th forum in Binghamton this week, local assemblyman Cliff crouch serves on that task force. Crouch told WCDO News that law enforcement officials testified that more has to be done from outside law enforcement:

(Crouch 10-22-15)

Crouch also said that part of the problem is that insurance and Medicaid covers 3 days of coverage after an overdose, which usually needs 7 days to get passed the high pain levels of withdrawal from heroin.

Attorney General Eric Schneiderman today announced the arrests of 68-year-old Kenneth Cohn and his wife, 64-year-old Sharon Cohn of Binghamton, for allegedly violating the Workers’ Compensation law and illegally obtaining over $1 million from the Medicaid system. while owning & operating Yellow Medi-Van and Taxi, Incorporated. The Cohns were charged with Grand Larceny, Offering a False Instrument for Filing among other charges, they were arraigned in Binghamton City Court.

Approximately 460,000 New York Medicaid recipients diagnosed with diabetes received diabetes-related services costing more than $1.2 billion in state fiscal year 2013-14, according to a report released by State Comptroller Tom DiNapoli. The report notes that about 1.6 million adult New Yorkers, or 10.3% of the adult population, have been diagnosed with either Type 1 or Type 2 diabetes, which is higher than the 3-year nationwide average of 9.6%.

State Comptroller Tom DiNapoli released 2 audits revealing more than $70 million in questionable Medicaid claims and payments. DiNapoli’s auditors found the state reimbursed providers for excessive services, including 41 dental exams for one patient over three years and identified about a dozen providers that should have been kicked out of the system for wrongdoing. DiNapoli recommended the Department of Health review the overpayments identified and make recoveries, strengthen controls over claims processing to prevent improper payments for excessive services; and review the duplicate Medicaid payments identified and recover, as appropriate. DOH officials generally agreed with the recommendations, but indicated that certain findings were outdated because actions have already been taken to address system shortcomings.

New York collected $149.1 billion in revenue in fiscal year 2014-15, an increase of $11.4 billion, or 8.3% from the prior year, largely because of one-time financial settlements and a boost in federal aid, according to a report by State Comptroller Tom DiNapoli. The state collected more than $71 billion in taxes, Business tax collections of $8.5 billion. The state received $48.6 billion in federal grants, which were used primarily for Medicaid, homeland security, public welfare and education.

State Comptroller Tom DiNapoli announced that audits identified a total of $513 million in improper Medicaid payments and untapped revenue opportunities over a 4-year period. Auditors identified another $361 million in questionable transactions that will require further review and actions to prevent overpayments or recover costs. The state expects to transition the majority of Medicaid spending, services, and enrollees to managed care by 2016, but recent audits by DiNapoli’s office highlight the need for more effective oversight of managed care organizations

The state Department of Health failed to collect nearly $120 million in available rebates over a 33-month period from pharmaceutical manufacturers for the Medicaid program because of ineffective policies and processes, according to an audit by State Comptroller Tom DiNapoli. Auditors determined that the Health department can improve its processes by following 12 recommendations from the report, to collect the unclaimed rebates and improve the collection process.

New York’s Medicaid system overpaid pharmacies by more than $1.1 million over a 5-year period for narcotics and other controlled substance prescriptions that exceeded limits allowed by the law, according to an audit of the Department of Health by State Comptroller Tom DiNapoli. Auditors determined DOH’s eMedNY claims processing system did not properly deny claims from pharmacies for controlled substances that exceeded the supply limits put in place by the Controlled Substances Act and thus prevent improper payment. Medicaid overpaid pharmacies $1.2 million for 13,705 improper claims.

State tax collections of just under $8 billion were $474.2 million higher than expected in December according to the December cash report issued by State Comptroller Tom DiNapoli. The state has also collected $4.2 billion from financial settlements since April, approximately $3.9 billion more than initially anticipated, with another $1.3 billion expected. Total receipts increased 6.5% through December 31st due to settlements and assessment revenues. Tax collections through the first three quarters increased 1.5% Spending from All Funds through December 31st was up by 5.3% from a year earlier, because of Medicaid and spending for education.

The state Department of Health inappropriately paid more than 29,000 pharmacy claims worth nearly $1 million over a 27-month period for thousands of Medicaid recipients whose benefits were already covered by other plans, according to an audit released today by State Comptroller Tom DiNapoli. A second audit released today found another $61,711 in overpayments to providers because of incorrect Medicare coinsurance, copayment or deductible amounts. DiNapoli recommended that the DOH Review and recover improper overpayments; instruct providers to bill Medicare Part C claims in accordance with existing requirements, & assess all claims that auditors did not examine in detail and determine if overpayments were made that warrant recovery.