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089589 1 (1976-05-24)

handle is hein.gao/gaobacvqg0001 and id is 1 raw text is: UNITED STATEs GENERAL ACCOUNTING OFFICE REGIONAL OFFICE 26 FEDERAL PLAZA NEW YORK, NEW YORK 10007 Mr. William Toby, Acting Regional Commissioner Social and Rehabilitation Service Region II Department of Health, Education and Welfare 26 Federal Plaza: New York, New York 10007 Dear Mr. Toby: During our review of the system for managing spend-down payments by the medically needy, we noted a matter which we believe warrants your attention. In New York State, the medically needy may have all or part of their medical expenses paid for under Medicaid. Those medically needy whose income and resources are above a State prescribed level must first incur a certain amount of medical expense - the spend- down amount - before they can receive assistance under Medicaid. In other words, these amounts are not eligible for Federal financial participation. Federal regulations provide that the payment of this spend-down amount is a matter between the medically needy and the provider of medical assistance. New York State, however, has been claiming Federal financial assistance for spend-down amounts relating to medical expenses in- curred by these medically needy at municipal and voluntary hospitals in New York City. Such Federal financial assistance amounted to about $1 million for voluntary hospitals during fiscal year 1975. Based on actual spend-down amounts billed by municipal hospitals for the 6-month period October 1975 through March 1976, we estimate Federal financial assistance for a 12-month period to be about $3 million. The passing on of costs incurred by these medically needy for Federal financial participation was previously identified in --an August 20, 1969, audit report by the HEW Audit Agency,

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