HHSOIG - A-02-17-01020 - 268165

Of the 100 sampled State agency claims for Federal Medicaid reimbursement of payments for PACT services, 50 complied with Federal and State requirements, but the remaining 50 did not. The deficiencies occurred because the State agency did not inform PACT providers of all Federal and State requirements for providing PACT services, and its monitoring procedures were not adequate to identify all instances when providers did not claim PACT services in accordance with these requirements. In fact, the monitoring procedures did not include checking whether some requirements were met. As a result, PACT providers did not follow requirements for providing PACT services.