Friday, September 13, 2013

Medicaid Fraud in Child Welfare has a new name

A few years ago I presented congressional testimony regarding home-based/community-based waiver programs for child welfare.  More intuitively, I forewarned of Medicaid fraud.

When there is an audit, the Department of Health and Human Services Office of Inspector General sets an agenda for the fiscal year of what will be prioritized for the scope of audits.  It seems the home-based, community-based programs under the child welfare waivers are targeted.  This audit is the first.

Residential habilitation is the latest technical term for youth who have aged out of foster care but are still under the authority of the state.

The majority, not all, of the targeted population of the waivers are for developmental disabilities, which describes the majority of youth in foster care.

Michigan has a program call Supportive Independent Living.  Here is an analysis I did of the program. 

Maryland was found to have its Residential Habilitation programs lacking in internal controls.  Michigan has yet to get to point of developing its Residential Habilitation programs but it seems rumor has it Vista Maria is on its way to building its own campus for Residential Habilitation program.  

Granted, Residential Institutions are still in existence, but they have come under fire with its conditions and treatment of residents coming to light.

Residential Habilitation, under the Medicaid waivers for child welfare, provides for more direct services and community living, but unless there are internal controls for billing and delivery of services, Medicaid fraud in child welfare will continue to thrive, just under a new name, Residential Habilitation.

If Maryland's agency was found to have claimed, at least, $20,627,705 in unallowable costs then there is a strong likelihood that 49 other states have done the same.  I can guarantee Michigan has.
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