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HRD-82-57 1 (1982-04-16)

handle is hein.gao/gaobabddy0001 and id is 1 raw text is: UNITED STATES GENERAL ACCOUNTING OFFICE A - 7 WASHINGTON, D.C. 20548 HUMAN RESOURCES DIVISION B-207033 APRIL 16.1982 The Honorable Richard S. Schweiker The Secretary of Health and Human Services 118197 Dear Mr. Secretary: Subject: Need to Establish Standards That Must Be Met Before Intermediate Care Facilities for the Mentally Retarded Can Obtain Medicaid Reimbursement (HRD-82-57) We recently looked at the growth of small, community-based intermediate care facilities for the mentally retarded (ICFs/MR). States in certain circumstances can temporarily waive compliance with Federal ICF/MR standards and can certify for Medicaid reim- bursement ICFs/MR which do not meet all the standards. With few exceptions, the 150 ICFs/MR having 15 clients or fewer initially certified by New York State had major deficiencies. Health Care Financing Administration (HCFA) Region II officials found that, when the State recertified these facilities, 67 still had major deficiencies, according to HCFA. HCFA is attempting to recover about $7 million of Federal Medicaid funds which it believes were inappropriately provided to the 67 facilities since their initial certification. So that Federal funds will be disbursed only to New York ICFs/MR, which meet program standards for adequate care, HCFA Region II and New York State officials have agreed that in the future ICFs/MR will not receive State Medicaid certification unless they meet at least 13 specific standards. (See enc. I.) The HCFA Region II agreement with New York State represents an attempt to assure that ICFs/MR meet basic and essential require- ments. However, since HCFA has the responsibility for assuring that all States apply appropriate certification standards, we be- lieve HCFA should establish which of the current 116 ICF/MR stand- ards cannot be waived and must be met before any State can certify facilities as eligible for Medicaid reimbursement. Such guidance would assist States in certifying new facilities and HCFA regional offices in reviewing the adequacy of State certification programs. (106209)

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