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Missouri Claimed Federal Reimbursement for Unallowable Personal Care Services Claims Submitted by The Whole Person, Incorporated

For the period October 1, 2008, through June 30, 2009, the Missouri Department of Social Services (State agency) claimed $143,000 in Federal reimbursement for personal care services submitted by The Whole Person, Inc. (Whole Person), that did not comply with all Federal and State requirements. Of the 100 line items in our sample, 9 line items did not comply with all Federal and State requirements; these errors included assessments or reassessments that were not performed within required timeframes, missing or unapproved plans of care, and an untrained beneficiary. These errors occurred because the State agency, the Missouri Department of Health and Senior Services (DHSS), and Whole Person did not adequately monitor the personal care services program to ensure that claims for Federal reimbursement complied with certain Federal and State requirements.

Filed under: Center for Medicare and Medicaid Services