Performance Audit Report, Administration of Medicaid Home Health Services Program, Department of Social And Rehabilitation Services 1986
The book Performance Audit Report, Administration of Medicaid Home Health Services Program, Department of Social And Rehabilitation Services 1986 was written by author Montana. Legislature. Office of the Legislative Auditor Here you can read free online of Performance Audit Report, Administration of Medicaid Home Health Services Program, Department of Social And Rehabilitation Services 1986 book, rate and share your impressions in comments. If you don't know what to write, just answer the question: Why is Performance Audit Report, Administration of Medicaid Home Health Services Program, Department of Social And Rehabilitation Services 1986 a good or bad book?
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The following sections discuss the lack of utilization reviews, the management controls in effect, and our conclusions and recommendations. The four major utilization controls are: 1 . maximum of 200 visits per recipient per year; 2. required prior authorization for monthly billings exceed- ing I^JOO per recipient; 3. co-payment of $1 payable by recipient per service; and 4. required prior authorization for equipment purchases over $75, UTILIZATION REVIEWS OF HOME HEALTH SERVICES There is prese...ntly only minimal review by SRS of the utiliza- tion of home health services. An SRS staff member is to review those cases where expenditures for services provided exceed $M00 a month or equipment purchases exceed $75. Since only a small number of cases fall within either of these limits, there is indepen- dent review of only a very few home health care cases. In addi- tion, the home health program is growing. Nine new home health agencies were added in six months. An adequate utilization review process would provide assur- ance the number of home health services is appropriate and whether services are being provided.
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