U.S. Wants State to Pay After Audit Of Youth Care
By JESSE Mckinley New York Times March 26, 2013
ALBANY - In another critical assessment of New York's multibillion-dollar Medicaid program, a federal audit says the state improperly claimed $27.5 million in reimbursements for services to mentally ill and emotionally disturbed children and teenagers.
The report by the Department of Health and Human Services, which will be released Tuesday, outlines many deficiencies in a program of family-based rehabilitation, similar to foster homes, that offers help with a variety of life skills, counseling and other emotional support for young people 5 to 19 years old.
But in a random sampling of 100 claims from January 2005 to December 2009, the department's inspector general found dozens of administrative errors or other oversights, including staff members' not maintaining the requisite number of face-to-face visits, unreviewed logs by so-called professional parents in the homes, and recipients who were either too old for the program or not living in their assigned homes.
"Rehabilitation providers," the audit says, "did not fully comply with state regulations" and did not "adequately monitor the program."
As a result, the department has asked for a refund of $27.5 million from the state, or nearly 80 percent of the $35.2 million it paid to New York during the five-year period it sampled.
Richard Azzopardi, a spokesman for Gov. Andrew M. Cuomo, noted that the audit covered a period before his administration began in January 2011. He added that the family-based program in question was being "phased out because it was difficult to manage and had questionable value." It ends Sunday, he said.
The inspector general audits reimbursement claims from states, sometimes for minor discrepancies but also for larger problems. And New York - which spends more on Medicaid than any other state - is regularly a subject of such audits, along with reports like one this month from the House Committee on Oversight and Government Reform, which accused the state of "billions of federal tax dollars misspent" but praised the governor's efforts to rein in costs.
In May, for instance, the inspector general found that the federal government had overpaid New York some $700 million in 2009 for the care of developmentally disabled residents. In November, he also found that the state had improperly claimed nearly $70 million in reimbursements for some home health services from 2007 to 2009.
Changes in Medicaid can cause budgetary agita in Albany. In February, Mr. Cuomo announced that the state budget would need $500 million more in cuts after federal officials said that the state had overbilled for services.
Mr. Azzopardi said that the Cuomo administration would review the most recent audit and "work with our counterparts in the federal government to resolve this situation."