HHS said it is beginning to review claims from 39 developmental disability service providers who received payments from federal and state funds under the Home & Community-Based Services Medicaid waiver program. The payment issue was divulged when officials began renewing the Medicaid waiver and found a difference between how provider rates were determined and CMS’ billing guidelines. The prior method was created by a former state HHS director.
Officials found that under the discrepant method, providers were paid for weekend services like job coaching and transportation. Medicaid officials told HHS it should stop the payments and reimburse any submitted claims. The claims total about $32 million.
The department will review claims since July 1, 2014, and the process may take a couple of months, according to the report. Changes to provider payments are expected to begin Oct. 1, with providers only receiving state funds for their weekend services.
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