Missouri Claimed $11.5 Million In Unallowable Medicaid Payments during SFY 2011-2013 For Targeted Case Management Services Provided To Individuals With Developmental Disabilities (A-07-13-03193)

In this report issued on November 7, 2014, the federal Office of the Inspector General (OIG) for the Department of Health and Human Services (HHS) reviewed the methodology used in 2010 by the Missouri Medicaid program to rebase payment rates for targeted case management (TCM) for individuals with developmental disabilities. The OIG said the Missouri Department of Mental Health (DMH) failed to follow the methodology in its state plan. Rather than using cost data from all provider organizations, the state used only the DMH regional state offices’ and 10 of the 38 other providers’ cost reports; some cost reports were . . .

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