The federal government would like the state of New York to return more than $54 million in improper Medicaid payments related to its personal care services program.
An audit by the Department of Health and Human Services’ Office of Inspector General revealed that the state received $54.4 million in Medicaid reimbursement for flawed personal care visits. Any or all of the following applied, according to the report: no independent medical review, no valid physician’s order or the order was not timely, no documentation of services provided and no plan of care. For some claims, the personal care aide who provided the associated services had not undergone a timely criminal history check or did not meet training requirements.
The audit did, however, recognize the state for increasing the number of monitoring visits of local districts and revising its procedures for conducting those visits.