Follow-Up Report on Prior Audit Recommendations Medicaid Home Help Program Michigan Department of Health and Human Services
Learn how the AI-generated research projects were createdOverall Conclusion
Partially complied. A reportable condition exists.
Source Document
Audit Scope
This follow-up report assesses whether the Medicaid Home Help Program (HHP) administered by the Michigan Department of Health and Human Services (MDHHS) has implemented corrective actions for the material condition identified in the December 2020 performance audit regarding monitoring of provider invoices and related payment accuracy. The scope covers the HHP payment process, including how invoices are supported and approved, the use of MiAIMS for client assessments and preauthorization, and CHAMPS for processing provider encounters. It includes policy updates (e.g., standardizing agency invoices, prorating IADLs, and supervisor approvals for single-party agency payments) and system improvements (Electronic Visit Verification, EVV, implementation) as well as staff training. The period of follow-up review encompassed October 1, 2023 through February 29, 2024, and the report analyzes a sample of 40 payments totaling $33,625 and a broader population of 232 payments totaling $204,240 for 125 clients and 119 providers, with a projection of overpayments and a summary of the agency’s compliance status.
Key Findings Summary
Material condition: MDHHS did not monitor HHP provider invoices adequately, leading to significant overpayments in the December 2020 audit (43.1% of 232 payments totaling $204,240 to 119 providers for 125 clients, with projected overpayments of $39.4 million ($13.9 million General Fund) over the two-year audit period). The follow-up results indicate ongoing …
AI-Assisted
AI Scope Summary
This follow-up assesses whether MDHHS’s Medicaid Home Help Program has implemented corrective actions for the material condition identified in the 2020 performance audit, focusing on provider invoice monitoring, payment accuracy, and the effectiveness of program controls, with attention to progress during October 1, 2023–February 29, 2024 and ongoing monitoring activities.
AI-Generated Insight
The follow-up shows progress in reducing improper payments since the 2020 audit, but MDHHS still faces material condition risk without stronger verification and documentation controls. The planned implementation of Electronic Visit Verification (EVV) and strengthened monitoring, pro-rating, and staff training are critical to further reducing improper payments and achieving full compliance.