Review of Medicaid Personal Care Services Claims Submitted by Providers in North Carolina

摘要

Pursuant to Title XIX of the Social Security Act, the Medicaid program provides medical assistance to low-income individuals and individuals with disabilities. The Federal and State Governments jointly fund and administer the Medicaid program. At the Federal level, the Centers for Medicare & Medicaid Services (CMS) administers the program. Each State administers its Medicaid program in accordance with a CMS-approved State plan. Although the State has considerable flexibility in designing and operating its Medicaid program, it must comply with applicable Federal requirements. Our objective was to determine whether the State agency ensured that claims for Federal reimbursement of Medicaid personal care services complied with Federal and State requirements.