State Audit on Case ManagementDecember 18, 2018
DDRC and the Community Centered Boards (CCBs) in Colorado serving people with intellectual and developmental disabilities (IDD) have many financial, health and safety, programmatic and other surveys and audits. Recently, the Colorado Office of the State Auditor conducted an audit of all 20 CCBs as required by state law.
The audit, which was a retrospective look from July 2016 through June 2017, was specific to Medicaid case management and State Supported Living Services (SLS) case management. The audit findings were approximately 1% of the case management budget statewide. Those findings showed a lack of adequate supporting documentation, such as lacking a signature, specified dates, choosing the correct activity on the state automated system, or log notes to verify that each case management activity that was billed took place. Adequate documentation is required for all case management activities to support billing and verify that the service occurred. DDRC did quite well with the audit results regarding in-person case management visits, which is the one area of this audit that captured actual service delivery.
DDRC, other CCBs and IDD stakeholders agree with the Colorado Legislative Audit Committee recommendations that the Colorado Department of Health Care Policy and Financing (HCPF) and the CCBs work together to find a more effective funding methodology for targeted case management other than 15-minute billing unit increments. Other concerns to be addressed include an end to the 240-unit cap on reimbursement per individual, ensuring state requirements and funding for State Supported Living Services are adequate, and improving the state required technology systems for documenting claims to HCPF.
DDRC and the CCBs statewide believe in the importance of the need to correct all processes that will lead closer to a 100% compliance rate. Since the state auditor’s retrospective look, HCPF, DDRC and other CCBs have implemented measures to strengthen documentation, billing processes and in-person case management monitoring. Further measures are also in progress.
All of these collective efforts in Colorado will further demonstrate to the Centers for Medicare/Medicaid Services (CMS) that Colorado’s Medicaid funding is being administered as intended.
DDRC has a long history of transparency, accountability and a commitment to best practices in meeting our mission. Our individuals, families, funders and community can be confident that DDRC will work with IDD stakeholders to find solutions to support great lives for people with IDD and their families.