Audit finds New York's Medicaid program lost nearly half a billion dollars by not enrolling eligible seniors in Medicare,
A recent audit by the New York State Comptroller's office found that the state's Department of Health (DOH) failed to enroll a significant number of Medicaid seniors in Medicare once they reached eligibility at age 65, resulting in nearly $485 million in missed cost savings since 2016. Program rules are intended to automatically shift payment responsibility from Medicaid, funded largely by the state, to federally-funded Medicare for eligible seniors, but gaps in enrollment processes and system limitations have hindered this transition. The New York State of Health marketplace, a key Medicaid enrollment portal, did not fully resume the automatic Medicare enrollment process post-pandemic, contributing to the under-enrollment issue. Although county departments of social services restarted eligibility checks in 2023, only a small fraction of eligible seniors have been converted to Medicare coverage.