New York paid $7.6M in Medicaid funding to ineligible incarcerated convicts
The blue state’s health department made monthly payments available to more than 1,300 imprisoned convicts, despite those convicts being ineligible to benefit from Medicaid, a federal audit found.
A new federal audit has found that Democrat-run New York made improper Medicaid payments to incarcerated convicts, totaling nearly $7.6 million in taxpayer funds. The Office of Inspector General (OIG) for the Department of Health and Human Services (HHS) published a report Sept. 23 that found the New York State Health Department made unallowable monthly payments for Medicaid services to be made available to incarcerated convicts.
The New York Health Department makes fixed monthly payments, called capitation payments, to managed care organizations for each eligible Medicaid enrollee. Incarcerated convicts are not eligible enrollees, but the OIG found that the New York OIG has been making capitation payments for those enrollees anyway.
“We conducted this audit to determine whether New York made unallowable capitation payments on behalf of incarcerated Medicaid enrollees and to identify the dollar amount of any unallowable capitation payments that were not recovered,” the OIG report said. “We reviewed capitation payments the State agency made to MCOs on behalf of 1,375 incarcerated enrollees.”
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Between 2021 and 2024, OIG found that the New York Health Department had made $7,551,670 in unallowable capitation payments on behalf of incarcerated convicts, of which $6,164,734 came from federal tax funds. The federal watchdog recommended that New York refund the $6,164,734 to the federal government, in addition to implementing safeguarding policies to ensure that Medicaid funding was not misused in the future.
“New York did not indicate concurrence or nonconcurrence with our recommendations,” the OIG report said, although the state health agency did claim that it is planning to craft new policies to prevent further misuses of Medicaid funding.
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President Donald Trump and his administration have made fraud a focal point for federal investigations, unearthing an estimated $230 billion defrauded from the federal government, much of it through healthcare schemes and Medicaid and Medicare payments. In numerous instances, those accused or convicted of fraud have allegedly created or used fake identities and fictitious persons to bill Medicaid and Medicare millions and billions of dollars.
Former Republican candidate for Mayor of Los Angeles Spencer Pratt alleged that state and local officials responsible for administering welfare funds in Democrat-run jurisdictions such as L.A. likely received illegal kickbacks from the fraudulent organizations receiving the funding.
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