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Massachusetts Medicaid Payments to Newton Health Care Center Did Not Always Comply With Federal and State Requirements

The Massachusetts Executive Office of Health and Human Services, Office of Medicaid (State agency), generally made Medicaid payments in accordance with Federal and State requirements to Newton Health Care Center (Newton). However, the State agency did not always adjust its Medicaid per diem payments to Newton by the amount of beneficiaries' cost-of-care contributions from resources, such as Social Security and pensions. As a result, the State agency's Federal claim was overstated by a total of approximately $28,000 ($16,000 Federal Share). We attributed the incorrect Medicaid payments to clerical and billing errors.