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首页> 美国政府科技报告 >New York State Improperly Claimed Medicaid Reimbursement for Some Home Health Services Claims Submitted by Certified Home Health Agencies.
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New York State Improperly Claimed Medicaid Reimbursement for Some Home Health Services Claims Submitted by Certified Home Health Agencies.

机译：纽约州对医疗认证家庭健康机构提交的一些家庭健康服务索赔的不当声明的医疗补助报销。

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Pursuant to Title XIX of the Social Security Act (the Act), the Medicaid program provides medical assistance to low-income individuals and individuals with disabilities. The Federal and State Governments jointly fund and administer Medicaid. At the Federal level, the Centers for Medicare & Medicaid Services (CMS) administers Medicaid. Each State administers its Medicaid program in accordance with a CMS-approved State plan. Although each State has considerable flexibility in designing and operating its Medicaid program, it must comply with applicable Federal requirements. Pursuant to section 1905(b) of the Act, the Federal Government pays its share of a States medical assistance expenditures under Medicaid based on the Federal medical assistance percentage, which varies depending on a States relative per capita income. In New York State, the Department of Health (State agency) administers Medicaid. The home health services program is operated by the State agencys Office of Long Term Care. Under the program, Certified Home Health Agencies (CHHAs) provide preventive, therapeutic, and/or rehabilitative services to Medicaid beneficiaries. Pursuant to Federal regulations, home health services are provided to a beneficiary at the beneficiarys place of residence and on his or her physicians orders as part of a written plan of care that the physician reviews every 60 days. Many providers use Form CMS-485, Home Health Certification and Plan of Care, as the required plan of care to document physicians orders for home health services. Pursuant to State requirements, home health aides must complete a basic training program in home health aide services or an equivalent exam approved by the State agency.

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