Open Recommendations

Pennsylvania Department of Human Services enforce the provisions in its managed-care agreements that allow sanctions or penalties to be imposed for noncompliance with or failure to meet performance and program standards indicated in the contract and subsequent related agreements

Pennsylvania Department of Human Services take steps to ensure that the MCOs comply with Federal and State requirements and its managed-care contracts relating to the nonpayment of PPCs

Pennsylvania Department of Human Services require the MCOs to: implement policies and procedures to prohibit payments for inpatient hospital services related to treating PPCs.

Based on its revised policy, terminate benefits for the 59 beneficiaries identified by our audit.

Based on its revised policy, identify and terminate benefits for the estimated 6,374 beneficiaries identified by our current audit who could not be located and whose benefits were suspended for 7 years or longer.

Based on its revised policy, identify and take appropriate action for the 20,710 beneficiaries identified by our 2011 audit whose benefits remained in suspense.

Implement controls to identify and terminate benefits to beneficiaries whose benefits were suspended for address or whereabouts unknown for 7 years or longer.

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Recommendation is not publicly available.

Recommendation is not publicly available.

Recommendation is not publicly available.

Recommendation is not publicly available.

Recommendation is not publicly available.