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Report File
Date Issued
Submitting OIG
Department of Health & Human Services OIG
Other Participating OIGs
Department of Health & Human Services OIG
Agencies Reviewed/Investigated
Department of Health & Human Services
Report Number
A-05-16-00021
Report Description

The Medicaid program pays for nonemergency medical transportation (NEMT) services that a State determines to be necessary for beneficiaries to obtain care. Prior OIG audit reports have consistently identified NEMT services as vulnerable to fraud, waste, and abuse.

Report Type
Audit
Location

MI
United States

Number of Recommendations
4
Questioned Costs
$4,503,738
Additional Details
https://oig.hhs.gov/oas/reports/region5/51600021.asp

Open Recommendations

This report has 4 open recommendations.
Recommendation Number Significant Recommendation Recommended Questioned Costs Recommended Funds for Better Use Additional Details
264375 No $0 $0

We recommend that the State agency • strengthen its controls over its process for reporting expenditures claimed for NEMT services.

264373 No $4,503,738 $0

We recommend that the State agency refund $4,503,738 to the Federal Government

264374 No $0 $0

We recommend that the State agency • improve its oversight and monitoring of its Medicaid NEMT brokerage program by requiring LogistiCare to strengthen its procedures to ensure that (1) NEMT services are adequately documented and the documentation maintained according to Federal and State regulations; (2) transportation provider qualifications meet State requirements; and (3) vehicle inspection, safety, and insurance requirements are met.

264376 No $0 $0

We recommend that the State agency • ensure that the State agency’s contract with the transportation broker contains provisions that (1) consider improper claims submitted by transportation providers to the transportation broker when developing future capitated rates paid by the State agency and (2) provide a means for the State agency to recoup funds from the transportation broker when contract provisions and State requirements are not met—a measure that, if incorporated, could result in cost savings for the Medicaid program.

Department of Health & Human Services OIG

United States