Healthfirst PHSP and St. Barnabas Community Health Plan

New York, NY: (Aug-07-07) A settlement was reached with two companies, Healthfirst PHSP and St. Barnabas Community Health Plan and the state attorney general's office. The companies, who administered health care for the state, agreed to return $7 million that they received through duplicate billings. The recovery stemed from an audit of the state Medicaid program by the state comptroller in 2004. The audit revealed that in many cases Medicaid recipients had mistakenly been assigned more than one identification number from the program administrators. A later investigation by the attorney general and the state Medicaid inspector general found that once multiple identification numbers had been entered into computer systems, more than one bill was often paid for a single patient.

As part of the settlement, Healthfirst PHSP has reimbursed the state about $6 million for duplicate payments received between July 2000 and November 2006. The attorney general said the second company, St. Barnabas Community Health Plan, which was also known as Partners in Health, agreed to reimburse the state for $902,000 in duplicate billings since 2000. The company stopped operations last year. [NEW YORK TIMES: MEDICAID BILLING]

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Published on Aug-8-07