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News on Medicaid Personal Care Services

According to a report by the Office of Inspector General (OIG) of the Department of Health & Human Services, taxpayers are paying for improper Medicaid claims for personal care services. Completed OIG work (as well as ongoing research) takes a hard look at Medicaid’s payment for these services around the country, with the two most recent reports related to audits looking at billing collections in Washington State and North Carolina. Additional reports will provide information for Nevada cities like Las Vegas and Henderson.

These audits recommend that Washington State and North Carolina refund over $61.1 million to the Federal Government. They also urge the Centers for Medicare & Medicaid Services (CMS) to review an additional $30.0 million in tax dollars that are possibly unallowable.

Personal care services are nonmedical services provided to help with daily activities like dressing, bathing, light housework, meal preparation, medication management and transportation. One single illness or accident can make it necessary for anyone to require assistance for these everyday activities, which is why correct medical revenue collecting is so important.

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