Review of Medicaid Claims for Beneficiaries Under the Age of 21 Who Reside in Institutions for Mental Diseases in New York State

EXECUTIVE SUMMARY:

This final report points out that New York, contrary to provisions of Title XIX of the Social Security Act, improperly claimed Medicaid funds of more than $7.6 million (Federal share) for the 4-year period ending June 30, 2001 for medical care provided residents under the age of 21 in institutions for mental diseases (IMDs).  The improper claims occurred because the State had not instituted the necessary controls to identify and preclude such claims.  In addition to a financial adjustment for the $7.6 million, we recommended procedural improvements that should preclude this problem in the future.