Review of Social Security Act Section 1915(c) Waiver Payments for Home and Community-Based Services at Trinity Services, Inc., July 1, 2004, through June 30, 2005

Our objective was to determine whether the Illinois Department of Healthcare and Family Services's (the State agency) claim for Medicaid reimbursement for home and community-based services (HCBS) provided by Trinity Services, Inc. (Trinity) during State fiscal year (SFY) 2005 complied with Federal and State requirements.  Of the 3,877 HCBS reviewed, 78 were unallowable because Trinity did not provide the services or did not meet documentation requirements.

We recommended that the State agency refund to the Federal Government the $50,670 paid to Trinity for unallowable HCBS claimed in SFY 2005 and require Trinity to implement internal controls to ensure it documents and claims reimbursement only for HCBS actually provided. The State agency did not address our first recommendation but stated it would use our findings to reiterate required policies and improve its administration of the HCBS program.