Department of Health
Inappropriate Medicaid Payments for Durable Medical Equipment While Recipients Resided in Nursing Homes
Charges for durable medical equipment are often included in the comprehensive Medicaid reimbursement rates for nursing homes. Accordingly, Medicaid generally should not be billed separately for these charges when such equipment is provided to nursing home residents. However, we found Medicaid sometimes was billed separately for this equipment. During our five-year audit period, we identified about $3.1 million in potentially inappropriate payments for such equipment. We recommended that the payments be investigated, all inappropriate payments recovered, and controls improved to prevent such payments in the future. In addition, we referred certain inappropriate charges to the State Office of the Medicaid Inspector General for further review and investigation.
For a complete copy of Report 2007-S-18 click here.
For a copy of the 90-day response click here.