New York Claimed Unallowable Room-and-Board Costs Under its Developmental Disabilities Program

摘要

Medicaid does not generally cover room-and-board costs incurred by community residential facilities under a States home and community-based services (HCBS) Medicaid waiver program. During an Office of Inspector General review of payment rates for residential habilitation services provided under a New York State (New York) developmental disabilities waiver program (a Medicaid HCBS waiver program), we observed that New York may be claiming such costs. The objective of this review was to determine whether New York claimed Medicaid reimbursement for unallowable room-and-board costs for residential habilitation services provided at State-operated residences under its developmental disabilities waiver program. Section 1915(c) of the Social Security Act (the Act) authorizes Medicaid HCBS waiver programs. A States HCBS waiver program must be approved by the Centers for Medicare & Medicaid Services and allows a State to claim Federal reimbursement for services not usually covered by Medicaid.