ALBANY, N.Y., August 28 – New York State paid $10 million for home care and transportation services that were likely not provided, according to two audits by state Comptroller Thomas P. DiNapoli.

In some instances, reimbursement claims listed services for hospitalized or deceased patients. These inappropriate payments occurred because the claims processing system designed to detect and prevent errors had failed, according to the Comptrollers Office.

Providing services to someone whos been dead for more than a month should raise red flags, said DiNapoli. These claims should never have been paid. New York spends billions of taxpayer dollars for Medicaid services. At the very least, we should make sure those dollars are spent on living patients. Theres a systemic problem in the Medicaid claims processing system. Theres too much fraud slipping through the cracks.

Auditors found eight cases where Medicaid paid for home care services, totaling $13,928, after the patients had already died. In one case, a home care provider billed for services more than a month after an individuals date of death.

The State Department of Health (DOH), which administers the Medicaid program, reimburses for home care services such as feeding, dressing, housekeeping, and assistance with other personal tasks that help the recipient live at home. Medicaid also pays for patients to get from their homes to medical providers.

DiNapolis audits found that the majority of overpayments for services occurred while the Medicaid recipients were hospitalized, indicating that these providers likely billed for services that were never provided. The payments occurred because DOHs eMedNY claims processing system did not detect and prevent these payments " a persistent problem that auditors have identified in several past audits.

Auditors found similar inappropriate payments for transportation services in an audit released in October 2002 because the claims processing system failed to detect them. In that prior audit, auditors reported that Medicaid made duplicate payments for more than $9.7 million for transportation services. According to DOH officials, they have not recovered any of these duplicate payments.

The audit found that one provider billed Medicaid $5,468.40 for around-the-clock home care services for 15 days even though the patient had been hospitalized. Another provider was paid $62,070 for questionable services provided by staff, and another $17,045 was paid to a provider for services provided by employees who were the Medicaid recipients spouse, parent, son-in-law, daughter, or daughter-in-law, which is not permitted under DOH guidelines.

The auditors recommended that DOH recover the inappropriate payments and implement appropriate changes to the eMedNY system to prevent these overpayments from occurring. In responding to the audit, DOH said that it believed that auditors had overstated some of the overpayments but noted that it was acting on several of the auditors recommendations.