Evidence record

New York Made Unallowable Managed Care Capitation Payments on Behalf of Incarcerated Medicaid Enrollees

Jurisdiction
New York
Audit organization
U.S. Department of Health and Human Services Office of Inspector General
Publication date
September 21, 2026
Source record
Original document linked
Open original reportOriginal source available

Findings

1

Recommendations

2

Scope

Scope includes capitation payments paid by New York State to managed care organizations for incarcerated Medicaid enrollees; reviewed 1,375 incarcerated enrollees.

Findings (1)

Each finding has a stable link.

  1. F-1416

    New York made unallowable capitation payments totaling $7,551,670 ($6,164,734 Federal share) on behalf of all 1,375 incarcerated Medicaid managed care enrollees in the audit.

Recommendations (2)

  1. R-1266

    Refund $6,164,734 (Federal share) for unallowable capitation payments made on behalf of incarcerated Medicaid enrollees.

    Related finding F-1416
  2. R-1267

    Strengthen policies and procedures to identify incarcerated individuals enrolled in Medicaid managed care.

    Related finding F-1416