The Missouri Medicaid Audit and Compliance Unit (MMAC) wishes to remind all In-Home Services and Consumer Directed Services providers that telephony or Electronic Visit Verification (EVV) is a program requirement.  Please visit our website post dated June 3, 2016  for more information.

Providers who do not utilize telephony or EVV may face sanctions, so providers are encouraged to contact MMAC at MMAC.IHSCONTRACTS@DSS.MO.GOV with any questions.

Missouri Medicaid Audit and Compliance (MMAC) wishes to remind Consumer Directed Services (CDS) providers about reporting requirements.  Please visit the MMAC website at mmac.mo.gov to review the “From the Director” post dated February 23, 2016.

CDS providers are required to file quarterly service and financial reports, annual service reports, and annual financial audits.

CDS providers who fail to submit these reports may face sanctions, so providers are encouraged to contact MMAC at MMAC.IHSCONTRACTS@dss.mo.gov with any questions.

The Missouri Medicaid Audit and Compliance Unit (MMAC) wishes to remind providers about incentives that are “kick-backs” and therefore not allowed.

The federal Anti-Kickback Statute is a criminal law that prohibits health care providers in a federal health care program from offering to exchange, or actually exchanging, anything of value to reward someone for referring business. Medicaid is a state and federally funded program.  Conviction for a single violation can result in a fine of up to $25,000 and imprisonment.  With or without a conviction, individuals may still be excluded from federal health care programs.

Missouri state regulation also prohibits these types of incentives.  It is a violation to make any payment to any person for referring someone for goods or services, when MO HealthNet is providing payment.  MMAC has received notice of providers offering incentives to MO HealthNet participants, and also offering incentives to employees to induce or refer participants.  Providers may face sanctions for these practices.

Please contact MMAC at MMAC.ReportFraud@dss.mo.gov with any questions.