California Claimed Medicaid Reimbursement For Some Nonemergency Medical Transportation Services in Los Angeles County That Did Not Comply With Federal and State Requirements

摘要

The Medicaid program pays for nonemergency medical transportation (NEMT) services that a State determines to be necessary for beneficiaries to obtain medical care. Because the Office of Inspector General (OIG) has consistently identified this area as vulnerable to fraud, waste, and abuse, OIG has conducted audits in multiple States since 2006. In California, we selected Los Angeles County for review because claims for NEMT services paid to transportation providers in this county represented 46 percent of all claims for these services statewide from July 1, 2010, through June 30, 2011. The objectives were to determine whether (1) the California Department of Health Care Services (State agency) claimed Federal Medicaid reimbursement for NEMT services in Los Angeles County that complied with Federal and State requirements and (2) transportation providers maintained documentation for drivers and vehicles associated with NEMT services in compliance with State requirements.