Department of Health

NAMI Deductions from Nursing Home Medicaid Claims (Follow-Up Review)

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 recipientís Net Available Monthly Income (NAMI), is calculated by the recipientís local social services district. In our prior audit report 99-S-49, 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. 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. In our follow-up review, we found that all our prior recommendations had been implemented and about $19 million in overpayments had been recovered.

For a complete copy of Report 2002-F-18 click here.
For a copy of the 90-day response click here.