New York improperly claimed Medicaid reimbursement for its Nursing Home Transition and Diversion Medicaid Waiver Program, the Office of Inspector General said last week.
The Department of Health and Human Services agency asked for the state to repay $466,614 to the federal government, noting that that amount of reimbursement did not comply with federal and state requirements. The state’s NHTD waiver uses Medicaid funding to help nursing facility residents move back into the community, or to prevent them from entering a nursing home.
Officials reached their decision after reviewing 100 beneficiary months. It found 31 of them had waiver program services not supported by the units biller. During two months, services were done by individuals whose qualifications were not documented.
The government watchdog called the magnitude of the errors and the financial impact “minimal.” For their part, state officials said that high staff turnover or inadequate training led to the unallowable services.
New York should update its NHTD Waiver Program Manual to reflect current waiver requirements and make sure to train personnel on how to claim Medicaid reimbursement for NHTD waiver program services, the OIG recommended.
While the state agreed it would update the manual, New York officials disagreed with the recommendation to repay the nearly $500,000 in funds. Instead, audits are underway, they said.