Significant and persistent compliance, payment and fraud vulnerabilities exist within the Medicaid program that covers home care for elderly and disabled people, according to a recent report from HHS’ Office of Inspector General.
In the report, the OIG highlighted some of the most significant program vulnerabilities related to personal care services the agency continues to see during federal investigations.
The OIG said since 2012, it has opened more than 200 investigations involving fraud, patient harm and neglect in the PCS program nationwide. According to the OIG, common PCS fraud schemes involve payments for PCS that were unnecessary or not provided. Sometimes, PCS investigations detected fraud schemes organized by caregiving agencies, involving numerous attendants and beneficiaries, while other investigations have targeted individual attendants and the beneficiaries these attendants claim to serve.
Source: OIG identifies widespread Medicaid fraud by home caretakers BECKERS HOSPITAL REVIEW