June 21, 2013

Medicaid Director Announces House Oversight Committee Interest in Managed Long Term Care

On June 20, 2013, at the Managed Care Policy Meeting, Jason Helgerson announced that the House Oversight Committee has asked CMS to investigate managed long term care plans related to the use and possible abuse of social day care programs in New York City.  Mr. Helgerson reminded Plans that enrollment from Social Day Care Programs will be reviewed by the Office of Medicaid Inspector General (OMIG) and that referrals have been made to the Attorney General’s Medicaid Fraud Control Unit. He indicated that any premiums paid inappropriately will be recouped. This announcement regarding the proliferation of social day care programs and the individuals enrolled in some of these programs was recently the subject of a New York Times article.

As previously reported on this blog, New York has reportedly surpassed the 100,000 mark in terms of the number of members enrolled in managed long term care, one of the Medicaid Redesign Team initiatives.

This post was contributed by Carla Williams. Carla can be reached at cwilliams@oalaw.com.