Submitting OIG:
Report Description:
New York improperly claimed reimbursement for 36 of 100 payments made to Medicaid Managed Long-Term Care (MLTC) plans. Specifically, New York did not ensure that MLTC plans documented eligibility assessments of program applicants and reassessments of those already in the program, and conducted these assessments in a timely manner. New York also did not ensure that the plans provided services to beneficiaries according to a written care plan. Further, New York did not ensure that the plans enrolled and retained only those beneficiaries who required community-based services, and disenrolled beneficiaries who requested disenrollment in a timely manner.
Date Issued:
Monday, September 11, 2017
Agency Reviewed / Investigated:
Submitting OIG-Specific Report Number:
A-02-15-01026
Component, if applicable:
Centers for Medicare & Medicaid Services
Location(s):
NY
United StatesType of Report:
Audit
Questioned Costs:
$0
Funds for Better Use:
$717,473,637
Number of Recommendations:
2
View Document:
Attachment | Size |
---|---|
21501026.pdf | 1.98 MB |
Additional Details Link: