Administration of Medicaid Payments to Nursing Facilities for Long-Term Care

Timeliness of audit process needs improvement.

Improvements needed to the cost settlement process.

Consideration of alternative reimbursement methodologies.

Improvements needed to the cost report acceptance process.

Cost report audit process needs improvement.

We recommend that MDHHS reevaluate its Medicaid LTC cost reimbursement methodology.

We recommend that MDHHS enhance its cost report submission and initial review processes.

We recommend that MDHHS improve its audit procedures to help identify unallowable costs and more consistently disallow unallowable costs.

We recommend that MDHHS improve the timeliness of its audit process and perform on-site audits at least once every four years.

We recommend that MDHHS improve the timeliness and accuracy of its cost settlement process.