Fraud in Self-Direction: What Does the Data Tell Us?

There is a pervasive and long-standing narrative that personal care services, and specifically self-directed personal care programs, are highly susceptible to fraud. This narrative stems from numerous publications from the Office of the Inspector General (OIG). However, when you look at the data, it is clear that fraud occurs at exceedingly low rates within personal care services and self-directed personal care.

During this session, Applied Self-Direction’s James Toews and Molly Morris reviewed Applied Self-Direction’s report analyzing data from the FY2020 annual report of Medicaid Fraud Control Units and their efforts to dispel the prevalent myth that self-direction is uniquely susceptible to fraud. James and Molly provided updates on ongoing conversations with OIG and discussed recommendations for self-direction stakeholders.