Medicaid Non-Emergency Medical Transportation Services
Learn how the AI-generated research projects were createdOverall Conclusion
Not effective
Source Document
Audit Scope
January 1, 2018 through December 31, 2019
Key Findings Summary
Improved controls needed over transportation provider eligibility verification.
Monitoring of broker contract needs improvement.
Improved documentation needed to support encounter claims.
View the Findings tab to see all 4 findings
AI-Assisted
AI Scope Summary
Building on the objective to assess the effectiveness of MDHHS's efforts to administer select NEMT services, a future audit could focus on improving provider eligibility verification, broker performance monitoring, robust encounter data documentation, and evaluating local-office NEMT services for access, quality, and cost-efficiency.
AI-Generated Insight
The audit finds material conditions in MDHHS's administration of Medicaid Non-Emergency Medical Transportation (NEMT), notably in provider eligibility verification and broker contract monitoring, with deficiencies in encounter data documentation and local-office evaluation. Strengthening governance, documentation controls, and performance monitoring could enhance beneficiary access and cost-effectiveness.
Audit Objectives
To assess the effectiveness of MDHHS's efforts to administer select NEMT services.
Audit Findings (4)
Improved controls needed over transportation provider eligibility verification.
Monitoring of broker contract needs improvement.
Improved documentation needed to support encounter claims.
Evaluation of local office NEMT services needed.
Recommendations (4)
MDHHS ensure its various NEMT coordinators maintain all required transportation provider eligibility documentation.
MDHHS better monitor its broker contract.
MDHHS implement processes to ensure the broker and MHPs maintain adequate documentation to support their NEMT encounter claims.
MDHHS establish performance indicators, identify performance standards, compile performance data, and evaluate NEMT services coordinated directly through its local offices.