Review of Program Integrity Operations At Six Managed Care Organizations Delivering Medicaid Services under a Contract with the South Carolina Department of Health & Human Services

The State contracted with six managed care organizations to deliver Medicaid managed care at an annual cost of $2.7 billion, representing 10% of the State’s annual budget, to 750,000 Medicaid beneficiaries in South Carolina. This review’s scope and objectives were: Test the six MCOs’ compliance and effective execution of the SCDHHS’s managed care contract “Section 11 - Program Integrity” focusing on the operational components of pre-payment review and post-payment review. Identify opportunities to improve SCDHHS’s biennial managed care contract, contract monitoring, and MCO compliance and effective execution of the contract.

President's Private Sector Survey on Cost Control : report on Department of Health and Human Services, Public Health Service/Health Care Financing Administration.

Mode of access: Internet.

Annual report of the U.S. Department of Health and Human Services to the Congress of the United States on services provided to handicapped children in Project Head Start.

Title from cover.

Background materials relating to Office of Inspector General, Department of Health and Human Services efforts to combat fraud, waste, and abuse [microform] /

"December 1981."

Budget issues : effects of the fiscal year 1990 sequester on the Department of Health and Human Services : fact sheet for the Chairman, Committee on Budget, House of Representatives /

"B-240472"--p.1.

Report on the Department of Health and Human Services--Public Health Service, Health Care Financing Administration /

Also known as: The Grace report.

Public health personnel in the United States, 1980 : second report to the Congress of the Secretary of Health and Human Services as required by section 793 of the Public Health Service Act.

Mode of access: Internet.

Departments of Labor, Health and Human Services, Education, and related agencies appropriations for 2012 : hearings before a subcommittee of the Committee on Appropriations, House of Representatives, One Hundred Twelfth Congress, first session /

Shipping list no.: 2011-0418-P (pt. 1), 2011-0423-P (pt. 2A), 2011-0426-P (pt. 2B), 2011-0439-P (pt. 3), 2011-0432-P (pt. 4), 2012-0085-P (pt. 5), 2012-0221-P (pt. 6), 2012-0256-P (pt. 7).

Departments of Labor, Health and Human Services, Education, and related agencies appropriations for 2011 : hearings before a subcommittee of the Committee on Appropriations, House of Representatives, One Hundred Eleventh Congress, second session /

Mode of access: Internet.

Departments of Labor, Health and Human Services, Education, and related agencies appropriations for 2013 : hearings before a subcommittee of the Committee on Appropriations, House of Representatives, One Hundred Twelfth Congress, second session /

Shipping list no. 2012-0243-P (pt. 1, 4), 2012-0266-P (pt. 2A), 2012-0267-P (pt. 2B), 2012-0250-P (pt. 3), 2013-0038 (pt. 5), 2013-0040-P (pt. 6), 2012-0298-P (pt. 7).

Departments of Labor, Health and Human Services, Education, and related agencies appropriations for 2014 : hearings before a subcommittee of the Committee on Appropriations, House of Representatives, One Hundred Thirteenth Congress, first session /

Mode of access: Internet.

Departments of Labor, Health and Human Services, and Education, and related agencies appropriations for fiscal year 1994 : hearings before a Subcommittee of the Committee on Appropriations, United States Senate, One Hundred Third Congress, first session.

Shipping list no. 94-0642-P (pt. 1).

Review of Abuse, Neglect, and Exploitation Allegations Involving SC Mentor, a Private Provider for the South Carolina Department of Disabilities and Special Needs

This review was requested by the Department of Disabilities and Special Needs for an independent review of allegations of abuse, neglect, and exploitation at SC Mentor, a private provider of residential services for DDSN consumers. An analysis of incidents did not indicate systemic abuse towards consumers inasmuch as the majority of the ANE reporting system contained allegations more akin to staff/facility performance issues and the vast majority of all allegations were unsustained by independent investigations. In the future, DDSN should expand the level of detail in its ANE reporting, which currently only reports total allegations and sustained criminal incidents.

Medicaid : improvements needed in programs to prevent abuse : report the the Secretary of Health and Human Services /

"B-228646"--P. [1].

Into the Spotlight: Bringing Transparency, Consistency, and Efficiency to the Division of Appeals and Hearings

Currently, the Division of Appeals and Hearings of the South Carolina Department of Health and Human Services has no specific presence on the agency's website to provide information or to allow for the electronic submission of appeals. This project's focus was developing an online presence for the Division on SCDHHS' website. The page will make the Division's procedures publicly available to beneficiaries, providers, and agency program staff who attend hearings. Additionally, parties will have a secure online portal through which they can file appeals and upload supporting documentation, reducing the need to send appeals via first class mail. The online appeal portal will further the agency' s goal of reducing paper.