Administration of Medicaid Payments to Nursing Facilities for Long-Term Care - 391-0570-18

Description of Agency

The Michigan Department of Health and Human Services’ (MDHHS’s) Long-Term Care Reimbursement Division administers the Medicaid cost reporting, rate setting, and reimbursement settlement processes for long-term care provided by nursing facilities. MDHHS coordinates the annual review of cost reports and sets the Medicaid long-term care reimbursement per diem rates for nursing facility providers. As of October 1, 2017, MDHHS provided long-term care payments to 369 nursing homes, 35 county medical care facilities, 20 inpatient hospitals with long-term care units, and 10 nursing homes with long-term care ventilator units. During fiscal years 2016 and 2017, MDHHS expended $1.7 billion annually for long-term care provided by nursing facilities.

Audit Objectives

  1. To assess the effectiveness of MDHHS’s efforts to administer the long-term care rate setting process.

  2. To assess the effectiveness of MDHHS’s efforts to administer the long-term care audit process.

  3. To assess the effectiveness of MDHHS’s efforts to administer the long-term care cost settlement process.

 

Timing

Estimated Release Date: Early 2019


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