Medicaid Adult Day Health Services

The OIG has issued a report entitled Medicaid Services Provided in an Adult Day Health Setting.” Based on a random sample of 300 adult day health service days from the last 6 months of 2007, the OIG found that: meals and/or snacks were the only documented services for Medicaid beneficiaries on 34% of service days; about 43% of therapy services were provided by staff who lacked required supervision; and in some cases documentation lacked appropriate physician orders or was inconsistent with plans of care. The OIG recommends that CMS: specify what services are required for Medicaid reimbursement of adult day health services; direct states to enforce therapy supervision requirements; and address the centers that did not respond to repeated OIG data requests. CMS concurred with the recommendations. 

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