BATON ROUGE, La. (AP) — Louisiana's health department spent up to $3.8 million on improper payments in recent years on programs that help the elderly and people with disabilities stay in their homes, according to an audit released Monday.

The review from Legislative Auditor Daryl Purpera's office said the Department of Health hasn't fixed several of the problems identified in a 2011 audit of Medicaid spending on home- and community-based services.

Though some recommendations were followed, auditors said the health department needs to improve its tracking and monitoring of direct care workers and the services billed to the Medicaid program to make sure people are getting the services charged to the state.

The report identified up to $1.3 million in improper spending on overlapping claims and services from 2011 through 2015, tied to uncorrected problems described in the 2011 audit.

New problems were also found. Auditors said they identified 100 workers who charged for $2.5 million in services though they were banned from the programs because of previous findings of abuse, neglect or other problems.

In a written response, the health department said it will work to make the changes recommended by auditors and is committed to correcting the problems. The agency suggested most of the fixes should be in place by December 2018.

The dollars are a small slice of annual spending on the Medicaid programs reviewed. The audit says Louisiana spent $749 million in state and federal dollars in the 2015-16 budget year on the programs, which provided services to nearly 34,000 people.