Department of Health
Medicaid Payments to Home Care Providers While Recipients Were Hospitalized Home care services can be reimbursed by Medicaid when they enable the recipient to live at home. We examined selected Medicaid payments for home care services and hospital services over a five-year period. We identified about $5.7 million in potentially inappropriate payments for home care services. The payments were potentially inappropriate because the recipients appeared to be hospitalized at the time the home care services were supposedly provided. We recommended that the Department of Health investigate the potential overpayments, recover all actual overpayments, and develop controls to prevent such overpayments in the future. We also recommended that the Department investigate the billing practices of certain home care providers, as our detailed review of medical records at one of these providers identified numerous inappropriate and otherwise questionable billing practices.
For a complete copy of Report 2006-S-77 click here.
For a copy of the 90-day response click here.
For a copy of the associated follow-up report click here.