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April 19, 2007

ShareMemo From North Carolina DHHS Secretary Carmen Hooker Odom About Community Support Service Audit Findings

 North Carolina Department of Health and Human Services auditors reviewed 20 Community Support Service (CSS) provider organizations; ten selected by statewide trade associations and ten selected by Local Management Entities (which coordinate regional service providers). The auditors chose 10 cases at random from each audited provider and evaluated the following factors: valid individualized treatment plan, a valid service order, a valid authorization for services, and case notes detailing the service delivered. The auditors found many specific examples of CSS misuse that will result in DHHS action against providers who are improperly administering services.

 The audits took place between February 12 and March 16, 2007. The audit team evaluated claims paid between August 1, 2006, and January 31, 2007.

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