Michigan Did Not Always Comply With Federal and State Requirements for Claims Submitted for the Nonemergency Medical Transportation Brokerage Program

Submitting OIG:

Department of Health & Human Services OIG

Report Description:

The Medicaid program pays for nonemergency medical transportation (NEMT) services that a State determines to be necessary for beneficiaries to obtain care. Prior OIG audit reports have consistently identified NEMT services as vulnerable to fraud, waste, and abuse.

Date Issued:

Thursday, June 14, 2018

Agency Reviewed / Investigated:

Department of Health & Human Services

Submitting OIG-Specific Report Number:

A-05-16-00021

Component, if applicable:

Centers for Medicare & Medicaid Services

Location(s):

United States

Type of Report:

Audit

Questioned Costs:

$4,503,738

Number of Recommendations:

View Document:

Attachment	Size
51600021.pdf	1.04 MB

Additional Details Link:

https://oig.hhs.gov/oas/reports/region5/51600021.asp

Recommendation Number	Recommendation Status	Significant Recommendation
264373	Open	No
We recommend that the State agency refund $4,503,738 to the Federal Government
264374	Open	No
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.
264375	Open	No
We recommend that the State agency • strengthen its controls over its process for reporting expenditures claimed for NEMT services.
264376	Open	No
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.

Recommendation Number

Recommendation Status

Significant Recommendation

Additional Details

264373

Open

We recommend that the State agency refund $4,503,738 to the Federal Government

264374

Open

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.

264375

Open