Pennsylvania Inspector General Reports $1.8 Million Recovery of Long-Term Care Funds

As picked up by several news media sources, Pennsylvania’s Office of Inspector General (OIG) released a statement on February 9, 2015 reporting that “from September 2014 through December 2014, [OIG] recovered more than $1.8 million in taxpayer funds from individuals who were ineligible to receive long term care benefits.”

Further, OIG reported these actions resulting in “over $709,000 in cost savings for the same period.  Cost savings represent future use of commonwealth funds that would have been expended for Long Term Care services on behalf of an ineligible individual.”

The timing of this press release strikes me as interesting.  I don’t recall seeing a three-month report before, nor does the press release disclose any details about the number of “ineligible” individuals this report represents. The recent press release merely states:

“In some instances, individuals or their personal representatives fail to disclose to the commonwealth income and/or assets such as real estate, stocks, or pensions in order to qualify the individual for Medical Assistance benefits.”

OIG makes an annual report on investigations and recoveries of all state funds, including long-term care.  Pennsylvania’s 2013-2014 Fiscal Year Annual OIG Report includes a statement that OIG “collected and cost avoided in excess of $9.9 million in long term care benefits.” The conflating of recovery of “past” improper payments with “costs avoided” in the annual report makes it difficult to compare the more recent three-month report, covering the end of the calendar year, to determine whether it represents a significant change. 

It is probably worth noting that the OIG head in 2014 was an appointee of outgoing Republican Governor Tom Corbett, while the new Pennsylvania Governor, with new appointments to make, is Democrat Tom Wolfe.