Corporate Compliance

GOV’T AUDIT INSIDER: Sufficient claims cost controls in California

Healthcare Auditing Weekly, January 11, 2005

California had sufficient internal controls to ensure that costs claimed for the Medicaid Personal Care Services program from July 1, 2002, to June 30, 2003, were in accordance with federal laws and regulations, according to an OIG audit report. The audit examined three counties-San Francisco, Alameda, and Sacramento-and determined that they had internal controls to review and authorize individual provider time sheets related to personal care services. During the audit, the OIG did the following:

  • Reviewed applicable federal laws and regulations

  • Reviewed relevant policies and procedures

  • Interviewed officials at California Health Services, the Department of Social Services, and the three counties

  • Reviewed agreements between Health Services and Social Services

  • Reviewed applicable sections of quarterly CMS-64 reports

  • Reviewed related internal controls for authorizing, reporting, and recording personal care service costs

  • Reviewed the individual provider timesheet authorization process for the three counties

    Click here to read the audit report, "Review of California's Internal Controls Over Costs Claimed For Medicaid Personal Care Services," (A-09-04-00036) issued December 8, 2004.

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