GAO: Medicaid Home, Community Care Create Financial Conflicts

Health Payer Intelligence January 17, 2018
Thomas Beaton

Home and community-based service (HCBS) programs funded by Medicaid may be vulnerable to financial conflicts of interests.

Home and community-based services (HCBS) programs funded by Medicaid require additional protections from possible financial conflicts of interest, a new GAO report found.

Program assessors, including HCBS providers, state and local agencies, and managed care plans, may over or underestimate financial resources to support HCBS programs, leading to inappropriate Medicaid spending.

HCBS program waivers sometimes lack requirements to communicate a potential conflict of interest to federal Medicaid officials, including profitability goals based on reducing care costs or bolstering Medicaid revenues, GAO explained.

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