On February 5, 2018, the Government Accountability Office (GAO) released a report entitled, Medicaid Assisted Living Services: Improved Federal Oversight of Beneficiary Health & Welfare Is Needed. The report responds to a 2015 request from Senators Susan Collins (R-ME), Claire McCaskill (D-MO), Elizabeth Warren (D-MA) and Orrin Hatch (R-UT), who asked for a review of Medicaid spending and federal and state oversight of care provided to Medicaid beneficiaries in assisted living. The report focuses on the health and safety of Medicaid beneficiaries living in assisted living. The GAO study identified some areas of weakness in defining critical incidents, reporting of this information to Medicaid agencies and making this information available to the public. Specifically, the report noted the following:
GAO Recommendations The GAO surveyed all state Medicaid agencies and interviewed officials in three states: Georgia, Nebraska and Wisconsin. The GAO also reviewed regulations and interviewed CMS officials in advance of making the following three recommendations to CMS:
1. The CMS Administrator should provide guidance and clarify requirements regarding the monitoring and reporting of deficiencies that states (state Medicaid agencies) using HCBS waivers are required to report on their HCBS annual reports.
2. The CMS Administrator should establish standard Medicaid reporting requirements for all states (state Medicaid agencies) to annually report key information on critical incidents, considering at a minimum, the type of critical incidents involving Medicaid beneficiaries, and the type of residential facilities (including assisted living) where critical incidents occur.
3. The CMS Administrator should ensure that all states (state Medicaid agencies) submit annual reports for HCBS waivers on time as required.
Read the full GAO report here. Review highlights from the GAO report here.