Report Materials
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.
Notice
This report may be subject to section 5274 of the National Defense Authorization Act Fiscal Year 2023, 117 Pub. L. 263.