Earlier this month national media outlets gave extensive coverage to a report released by the Government Accountability Office (GAO) calling upon the Centers for Medicare and Medicaid Services (CMS) to bolster its oversight of Medicaid home- and community-based services (HCBS) in the assisted living setting. While Virginia makes limited use of Medicaid to pay for AL services, the report, which was prepared at the request of the Senate Aging Committee, signals increased scrutiny of AL and HCBS.

The report explains how states and CMS oversee HCBS waiver programs, specifically for coverage of services in AL. It also provides descriptive statistics on the state-reported number of Medicaid beneficiaries receiving services in AL and Medicaid spending on these beneficiaries. The report notes that Virginia has only 59 Medicaid beneficiaries receiving services in an assisted living facility.

Generally, the report’s evaluation calls for better state reporting of critical incidents, with more guidance and enforcement needed from CMS on exactly what information states must report. The report makes three recommendations directed at CMS to improve the guidance the agency provides regarding monitoring and reporting deficiencies; the standardization of reporting requirements for all states to report key information critical incidents; and timely annual reporting for HCBS waivers. 

Additional Information

• Follow this link to read the full GAO report: MEDICAID ASSISTED LIVING SERVICES: Improved Oversight of Beneficiary Health and Welfare Is Needed
• Read more from Provider: GAO Report Examines CMS Oversight of Assisted Living Facilities (February 5, 2018).