Purpose

To determine the extent of implementation of the four recommendations included in our initial audit report, Enhanced Medicaid Payments to Selected Home Health Care Service Providers (Report 2009-S-25).

Background

Our initial audit report, which was issued on September 24, 2010, examined whether selected home health care providers properly used Medicaid funds for the recruitment, training, and retention (RTR) of direct care staff and whether the Department of Health (Department) was effectively overseeing this funding. An amendment to the Public Health Law provided for $500 million in additional Medicaid funding, from 2006 through 2011, to organizations that provide certain home health care services to Medicaid recipients. The organizations were to use the supplementary funds to improve RTR of direct home health care staff. We reviewed $39 million of RTR funds and found indications that providers were using some of the funds as intended; however, we were unable to fully account for providers' use of RTR funds because these funds were commingled with other funds. We attributed these deficiencies to the Department providing insufficient guidance to the providers on how to use the funds and weak oversight of providers' use of the funds. We made four recommendations for improving the Department's oversight of RTR funds and for providing assurance that funds are used as intended.

Key Findings

Department officials did not implement the four recommendations we made in our initial audit report and further actions are still needed.

Key Recommendations

Officials are given 30 days after the issuance of the follow-up report to provide information on any actions that are planned to address the unresolved issues discussed in this report.

Other Related Audits/Reports of Interest

Department of Health: Enhanced Medicaid Payments to Selected Home Health Care Service Providers (2009-S-25)