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 damning state audit found today.
...The audit found that the state:
• overpaid 80 agencies $6.8 million by not making sure they met requirements to get higher fees than individual aides.
• hired a contractor in 2008 for $1.4 million to visit DHS county offices over three years to review home health cases, yet the case file reviews were not forwarded to the offices for corrective action on time. The Community Health Department blamed a lack of staff for the delay.
• inappropriately paid $3.5 million for home services when the 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.
Auditors said nearly 3,800 home health providers had felony convictions, including 572 convictions for violent crimes. The state said it has been considering background checks for years, but clients can hire family members to care for them and may be fully aware and accepting of their criminal history.
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