Federal Audit Of 8 HCBS Waivers In 4 States Finds At Least $176 Million In Unallowable Costs

Federal audits of eight home- and community-based services (HCBS) Medicaid waivers in Maryland, New York, Missouri, and South Carolina found at least $176 million in federal reimbursement for unallowable room-and-board costs. The $176 million in unallowable room-and-board and related costs represented about 2.0% of total Medicaid claims for the eight HCBS waivers during the audit periods. The key problem was that the states failed to always exclude unallowable room-and-board costs when determining payment rates under the HCBS waiver program. Across the four states, the unallowable costs totaled $91 million for improper room . . .