Michigan improperly spent on Medicaid

$160 million wrongly spent over three-year span.

6/18/2014

LANSING — Michigan improperly spent $160 million over three years caring for Medicaid recipients needing in-home services primarily because it failed to obtain invoices and other required documentation from service providers, a state audit found Tuesday.

The expenditures accounted for 18 percent of nearly $894 in joint federal-state spending on the Medicaid Home Help Program that serves about 67,000 people a year.

Auditors warned that Michigan could be forced to repay nearly $97 million to the U.S. government.

They said state caseworkers did not meet with clients to review their care or talk with home health aides to ensure the patients had not fired them and kept government payments for themselves.

The state Community Health and Human Services agencies also probably improperly paid home aides unemployment benefits, including one who was fired by a Medicaid recipient for having illegal drugs and taking the client’s medications, the audit said.

The review of the program covered October, 2010, through August, 2013, and mostly coincides with Gov. Rick Snyder’s administration. Residents with disabilities or cognitive impairments living at home are helped with eating, bathing, dressing, and other activities.

Auditors said nearly 3,800 of roughly 70,000 home health providers had felony convictions, including 572 convictions for violent crimes. The audit also found that the state:

● Overpaid 80 agencies $6.8 million by not making sure they met requirements to get higher fees than individual aides.

● Paid $3.5 million for home services inappropriately when patients were instead being hospitalized or in nursing homes.

● Did not review thousands of W-2 forms returned as undeliverable, missing a chance to crack down on clients fraudulently getting services or their relatives providing a false address to avoid cuts in the clients’ authorized service level.

● Failed to create a process for caseworkers to refer suspected fraud to the attorney general’s office.