Submitting OIG:
Report Description:
The New York State Department of Health (State agency) claimed Medicaid reimbursement for some adult day health care services (ADHC) provided by Metropolitan Jewish Health System (MJHS) that did not comply with certain Federal and State requirements. Of the 100 claims in our random sample, the State agency properly claimed Medicaid reimbursement for 80 claims. Of the remaining claims, 18 contained services that did not comply with Federal and State requirements, and, for 2 others, we could not determine whether the associated services complied with Federal and State requirements. We estimated that the State agency improperly claimed at least $1.1 million in Federal Medicaid reimbursement for ADHC services provided by MJHS that that did not comply with certain Federal and State requirements.
Date Issued:
Wednesday, November 25, 2015
Agency Reviewed / Investigated:
Submitting OIG-Specific Report Number:
A-02-12-01024
Component, if applicable:
Centers for Medicare & Medicaid Services
External entity, if applicable:
Metropolitan Jewish Health System
Location(s):
NY
United StatesType of Report:
Audit
Questioned Costs:
$1,179,261
Funds for Better Use:
$0
Number of Recommendations:
2
View Document:
Attachment | Size |
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Additional Details Link: