Department of Health
NAMI Deductions from Nursing Home Medicaid Claims Medicaid recipients in nursing homes are responsible for paying a certain amount of their nursing home costs each month. This amount, which is termed the recipient's Net Available Monthly Income (NAMI), is calculated by the recipient's local social services district. We reviewed the accuracy of the Medicaid payments made to nursing homes over a four-year period and found that many of these payments were probably not correct because of inaccuracies and delays in updating NAMI calculations. Our detailed examination of a sample of 637 claims totaling $964,898 determined that 318 of the claims (50 percent) were incorrectly paid (191 of the claims were overpaid by a total of $186,561, and 127 of the claims were underpaid by a total of $277,230). We recommended that the NAMI calculation process be automated to a greater extent and certain other improvements be made to improve the accuracy of the Medicaid payments made to nursing homes.
For a complete copy of Report 99-S-49 click here.
For a copy of the 90-day response click here.