Self-Directed Supports in a Changing Environment: Building Program Integrity

2017 Self-Direction Conference Breakout Session: In December of 2016 US Department of Health and Human Services Office of Inspector General (HHS/OIG) issued its 2017 work plan which states the OIG will create ‘Data Brief on Fraud in Medicaid Personal Care Services’. The data brief is presumed to back the 2013 OIG Report claims that potential for fraud and abuse is high because of the characteristics of Medicaid Personal Care Services. On December 13, 2016, the Centers for Medicare and Medicaid Services (CMS) issued a bulletin: “Strengthening the Program Integrity in Medicaid Person Care Services”. 

During this presentation, the presenter reviewed these claims, recommended program integrity approaches, and discussed how one program has implemented approaches within its self-directed supports program.