Evidence record
Follow-Up Report on Prior Audit Recommendations Medicaid Home Help Program Michigan Department of Health and Human Services
- Jurisdiction
- Michigan
- Publishing agency
- Michigan Office of the Auditor General
- Publication date
- November 8, 2024
- Source record
- Original document linked
Findings
1
Recommendations
1
Overall conclusion
Partially complied. A reportable condition exists.
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.
Findings (1)
Each finding has a stable link.
- F-602
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 issues, including 4 overpayments totaling $367 in 40 payments reviewed, and 10% of sampled cases with errors in the Oct 1, 2023–Feb 29, 2024 period, projecting $2.4 million in overpayments (including $857,891 General Fund) and a remaining reportable condition.
Recommendations (1)
- R-525
Continue to improve monitoring to ensure invoices are supported and accurately reflect HHP services provided.
Related finding F-602