New York State Improperly Claimed Medicaid Reimbursement for Some Adult Day Health Care Services 

The New York State Department of Health (State agency) claimed Medicaid reimbursement for some Medicaid adult day health care (ADHC) services 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 60 claims. However, the State agency claimed Medicaid reimbursement for services that were unallowable for the remaining 40 claims. On the basis of our sample results, we estimated that the State agency improperly claimed at least $70 million in Federal Medicaid reimbursement for ADHC services that did not comply with certain Federal and State requirements.