OIG Posts Investigative Advisory on Medicaid Personal Care Services (PCS)
In this Oct. 3rd investigative advisory, the Office of the Inspector General (OIG) identifies concerns about fraud and patient harm that build upon those outlined in a previous Portfolio report issued in November 2012, Medicaid Personal Care Services: Trends, Vulnerabilities, and Recommendations for Improvement.
Since the 2012 report, OIG has opened more than 200 federal criminal investigations involving fraud and patient harm and neglect in the PCS program across the country. Their investigations have revealed a variety of billing fraud scenarios. They continue to recommend that the Centers for Medicare and Medicaid Services (CMS) more fully use their authority to improve oversight and monitoring of personal care services across all states.
The investigative advisory highlights numerous significant PCS program vulnerabilities that include billing, payment, fraud, and patient safety. The State Medicaid Fraud Control Units (MFCUs) report PCS as a top fraud concern.
Contact: Cheryl Udell, cudell@leadingageny.org, 518-867-8871