Michigan
Michigan Office of the Auditor General
Published December 11, 2020

Medicaid Home Help Program

Learn how the AI-generated research projects were created

Overall Conclusion

Moderately effective.

Source Document

Audit Scope

October 1, 2017 through September 30, 2019; to examine and evaluate MDHHS's records and processes related to administering the Medicaid Home Help Program.

Key Findings Summary

1

Improved monitoring of provider invoices needed.

2

Improved controls needed to prevent or recover improper payments.

3

Review of undeliverable W-2 forms needs improvement.

View the Findings tab to see all 4 findings

AI-Assisted

Generated by gpt-5-nano

AI Scope Summary

This audit examined MDHHS's administration of the Medicaid Home Help Program from October 1, 2017 through September 30, 2019 to assess the effectiveness of program administration. The findings identify material and reportable conditions related to monitoring and recovering improper payments, following up on undeliverable W-2 forms, and improving unemployment information sharing with UIA. The report provides actionable recommendations to enhance provider invoice verification, eligibility monitoring, and information flows, offering a foundation for future Medicaid audits of home-based care programs.

AI-Generated Insight

The Medicaid Home Help Program audit identifies material and reportable conditions centered on payment accuracy and eligibility monitoring. The agency overpaid a substantial portion of provider payments, and several findings indicate gaps in monitoring, eligibility validation, W-2 follow-up, and unemployment information sharing with UIA. The report recommends process enhancements, policy updates, staff training, and data-sharing improvements, including automation and potential EVV integration, to strengthen controls and support future audits of HHP administration.

Audit Objectives

1

To assess the effectiveness of MDHHS's efforts in administering HHP.

Audit Findings (4)

1

Improved monitoring of provider invoices needed.

2

Improved controls needed to prevent or recover improper payments.

3

Review of undeliverable W-2 forms needs improvement.

4

Improvements needed in responding to unemployment inquiries.

Recommendations (4)

1

MDHHS should improve its monitoring to ensure that invoices are supported, properly approved, and accurately reflect the HHP services provided.

2

MDHHS should enhance its controls to prevent or recover payments for HHP services relating to instances where the client and/or provider no longer meet eligibility requirements.

3

MDHHS should follow up on W-2 forms that are returned as undeliverable to help identify potential fraud and abuse.

4

MDHHS should provide UIA with sufficient information to help limit its unemployment insurance liability.