Open Recommendations

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.

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.

Clearly define all the roles to be used in the agency’s OEP.

Develop and implement an effective OEP team training program with drills and exercises to include all team members at least annually.

Develop and implement procedures to address the needs of individuals requiring additional assistance. These procedures should include a process to routinely update the list of persons requiring assistance.

Develop and implement procedures to maintain, retain, and update OEP program documents at least semi-annually.

Develop and implement an annual round-table discussion with OEP coordinators and teams.

Develop and implement facility-specific policies and procedures.

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.

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.

We recommend that the State agency refund $74,871,340 to the Federal Government.

We recommend that the State agency ensure that the 200 instances of noncompliance with health and safety and administrative requirements identified in this report are corrected.

We recommend that the State agency consider developing templates for administrative records the State requires.

We recommend that the State agency ensure the health and safety of vulnerable adults by considering staffing standards and caseload thresholds for State licensors.

We recommend that the State agency review retrospective review reports for our audit period and after our audit period to determine whether payments should be reduced for any claims that contain PPCs and refund to the Federal Government its share of any unallowable amounts.