Department of Health

Medicaid Payments for Personal Care Services (Follow-Up Review)

Personal care services consist of feeding, housekeeping and other tasks that enable a patient to live at home. In our prior audit report 2001-S-14, we determined that New York’s Medicaid program paid $1.5 million for personal care services for periods during which the Medicaid recipients were not living at home, but were either hospitalized or living in nursing homes. We recommended that these claims be investigated by the Department of Health, and all overpayments be recovered. In our follow-up review, we found that the Department implemented our recommendation, identified an additional $2 million in overpayments, began collecting the overpayments, and planned to test for such overpayments regularly. Our prior audit also determined that the approval process for personal care services needed to be strengthened, and in our follow-up review, we found that actions had been taken to strengthen the process.

For a complete copy of Report 2003-F-44 click here.