Press Release  Audits Call for Improvements at Plymouth & Hopkinton Adult Day Health Providers

Boston — State Auditor Suzanne M. Bump today released a pair of audits calling for improvements to the documentation of services billed to MassHealth by Cozy Corner Adult Day Health of Plymouth and Liberty Adult Day Health in Hopkinton.

The audit found deficiencies with both providers’ documentation to support MassHealth claims for adult day health (ADH) services. It calls on both providers to improve their documentation for future claims and repay the Commonwealth for claims with inadequate documentation. In addition, the audit calls on Liberty to make improvements to physician orders detailing specific assistance needed by members. In its responses to the audits, MassHealth indicates it will work to recoup any improper payments and conduct its own audits of the providers.

“MassHealth’s adult day health program allows thousands of elderly people and people with disabilities in Massachusetts to maintain productive and independent lives,” Bump said. “To maintain public trust in this important program, it is imperative that providers accurately and thoroughly document the services provided, as well as the physicians’ orders for those services. I commend MassHealth for taking these findings seriously and working with the providers to address these issues.”

MassHealth covers claims for ADH services for members who need assistance with activities of daily living such as eating, using the restroom, bathing, walking, and taking medication.

Liberty Adult Day Health, which was previously known as Hopkinton Adult Day Health Center, became a certified MassHealth ADH provider in May 2014. During the audit period, it provided adult day health services to 72 MassHealth members and received approximately $1.3 million in payments from the program.

Cozy Corner Adult Day Health became a certified MassHealth ADH provided in March 2009. During the audit period, it provided services to 47 MassHealth members and received $955,587 in payments from the program.

In fiscal year 2017, MassHealth paid healthcare providers $15.3 billion for services for approximately 1.9 million low-and-moderate income individuals. It is the state’s largest program and accounts for approximately thirty-nine percent of the state budget.

The audit of Cozy Corner Adult Day Health is available here.

The audit of Liberty Adult Day Health is available here.

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