RD382 - Report of the Activities of the DMAS Advisory Group on Audit Methodology for Home- and Community-Based Services - December 1, 2012

Executive Summary:
This report responds to Item 307 YYY of the 2012 Appropriations Act (Attachment 1) which directs the Department of Medical Assistance Services (DMAS) to establish an advisory group of representatives of providers of home- and community-based care services to continue improvements in the audit process and procedures for utilization and review audits of these providers. In addition, Item 307 YYY requires a report by December 1, 2012, on any revisions to the methodology for home- and community-based utilization and review audits, including progress made in addressing provider concerns and solutions to improve the process for providers while ensuring program integrity. DMAS worked with providers to establish this advisory group and held two meetings during summer 2012. The following report gives an overview of changes DMAS and its contract auditors have made to the audit process as a result of provider concerns, as well as an overview of issues discussed during the advisory group meetings.