Missouri Claimed Unallowable Medicaid Payments for Individualized Supported Living Habilitation Services

The Missouri Department of Social Services, Missouri HealthNet Division's (State agency) Medicaid payment rates for individualized supporting living (ISL) habilitation services provided and paid for during State fiscal years 2011 through 2013 were not always in accordance with Federal requirements. Specifically, the State agency included costs that were not approved in some of its payment rates for ISL habilitation services. In addition, the State agency included unallowable costs in some of its payment rates for these services. Because these unapproved and unallowable costs were prohibited under Federal requirements, the associated payments were unallowable.

The State agency administers the provision and payment of Medicaid services in Missouri. ISL habilitation services are provided under Missouri's developmental disabilities waiver program, which is one of several Medicaid home and community-based services waiver programs and which is operated by the Missouri Department of Mental Health.