Skip Navigation
United States Flag

An official website of the United States government. Here's how you know >

U.S. Flag An official website of the United States government.
Change Font Size

New York State Improperly Claimed Medicaid Reimbursement for Continuous 24-Hour Personal Care Claims in Ulster County

The New York Department of Health's (State agency) claims for Federal Medicaid reimbursement for high-dollar continuous 24 hour personal care services provided to beneficiaries in Ulster County, totaling $6.3 million, did not comply with Federal and State requirements. This occurred because (1) the local social services district (the district) did not comply with requirements for assessing and approving continuous 24-hour personal care services and (2) the State agency did not adequately monitor the district's administration of the Ulster County personal care services program. High-dollar claims included services for beneficiaries with total Medicaid paid amounts greater than $10,000.

We recommended that the State agency (1) refund $6.3 million to the Federal Government and (2) improve its monitoring of the district to ensure the district's compliance with Federal and State requirements related to continuous 24-hour personal care services. The State agency did not indicate concurrence or nonconcurrence with our first recommendation (financial disallowance) and generally agreed with our second recommendation.

Copies can also be obtained by contacting the Office of Public Affairs at Public.Affairs@oig.hhs.gov.

Download the complete report.

Office of Inspector General, U.S. Department of Health and Human Services | 330 Independence Avenue, SW, Washington, DC 20201