Fraud in Self-Directed Personal Care Services: What Does the Data Tell Us?

In this report, Applied Self-Direction analyzes data from the FY2020 annual report of Medicaid Fraud Control Units to better understand the prevalence of fraud in self-direction. We found that the prevalence of fraud in self-direction is very low, despite representing the largest share of fraud cases across the Office of the Inspector General (OIG)’s broad portfolio. It is our goal that this report may serve as a tool to dispel the prevalent myth that self-direction is uniquely susceptible to fraud. The report includes recommendations to support continued fraud prevention and to improve the quality of available data.