The CMS is failing in its oversight of Medicaid long-term-care waivers for home- and community-based alternatives to nursing homes, according to the General Accounting Office. Such alternatives include adult day care and assisted-living facilities. The GAO looked at 15 of the largest waivers given to states for elder care and found quality problems in 11 programs. The most frequent problems included failure to provide necessary services, weaknesses in plans of care and inadequate case management. What's more, the extent of such problems is unknown because many state waivers hadn't been reviewed recently by the CMS or the states' annual reports to the CMS lacked relevant information, the GAO said. Medicaid spending for alternative long-term care reached 19% of total Medicaid long-term-care spending, or $14.4 billion, in 2001, up from 5%, or $1.6 billion, in 1991. The report is available on the GAO's Web site, www.gao.gov, under new reports. -- by Tony Fong
Long-term-care waivers need more oversight: GAO
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