Did NYC Overbill Medicaid?


New York City is accused of overbilling Medicaid for millions of dollars by improperly approving home care for thousands of city patients. It turns out that a 2006 adjustment to Medicaid rules absolved the city of responsibility for providing round-the-clock care. A suit filed by the U.S. attorney’s office insinuates that the city knowingly attempted to bilk money out of Medicare by enrolling people in home care that did not need it, or who required more intensive services. Like who? The suit cites a 75-year-old woman “with dementia who tried to jump out her window several times a day and who punched her daughter was kept in the home care program” when she should have been placed in an “appropriate facility.” The suit also claims that the city failed to follow proper protocol in obtaining recommendations from nurses, doctors, and therapists. A spokesperson from the city’s Human Resources Administration declined to comment. [NYT]