Criminals, lax oversight threaten Michigan home care

Michigan's Medicaid Home Help Program overpaid $160 million in 29 months for services meant to keep elderly or disabled people out of costly care settings, according to a report by the state's auditor general. Improper payments resulted from sloppy paperwork and lack of monitoring and follow-up by Michigan's Departments of Community Health and Human Services, the Detroit Free Press reported.

The audit revealed 5 percent of the program's home help aides--or 3,786 workers--are convicted felons. Their collective backgrounds include 572 convictions for violent crimes including homicide and assault, 285 sex-related convictions, 1,148 convictions for fraud, identity theft and other financial crimes, and 2,020 convictions for drug-related offenses.

Another program integrity risk stems from failure to get required documentation from providers and meet with clients to verify provision of care, the audit found. These errors resulted in $160 million in improper payments.

Moreover, the state paid at least $3.3 million in benefits on behalf of ineligible recipients.

And program workers failed to refer cases of suspected healthcare fraud by clients and providers to authorities for investigation, the audit report stated.

Michigan's Home Help Program supports more than 66,000 beneficiaries by assisting them with routine activities such as laundry, light housekeeping and personal care, the Free Press reported.

Unlike traditional in-home care where agency-based medical professionals provide services, Michigan's program allows beneficiaries to choose their caregivers. These are often friends or family members who earn between $8 and $11 dollars an hour for their help, the Associated Press reported.

In response to the audit findings, the state's Department of Community Health Director James Haveman told the AP home help workers will soon have to undergo criminal background checks even though such screening isn't legally required.

Haveman believes that people convicted of murder, sex offenses or Medicaid fraud shouldn't participate in the program even if beneficiaries hire them will full knowledge of their rap sheets, the AP reported.

For more:
- see the audit report (.pdf)
- read the Detroit Free Press article
- here's the AP article

Suggested Articles

The HHS OIG is asking for an additional $23.7 million to support fraud oversight that has benefited from an emphasis on data analytics.

A New York surgeon was sentenced to 13 years in prison for fraud and more physician practice news from around the web.

A federal judge has ruled that the U.S. government’s remaining fraud case against UnitedHealth can move forward.