GAO Releases Report on Conflict of Interest in HCBS Program

The Government Accountability Office (GAO), which reports to Congress, issued a report last week recommending that the Centers for Medicare and Medicaid Services (CMS) expand requirements for states to address potential conflicts of interest in the Home and Community Based Services (HCBS) program. Specifically, GAO is concerned that both HCBS providers and managed care plans may have a financial interest in the outcomes of needs assessments. GAO also notes the lack of uniformity in standards for conflicts of interest and that not all HCBS programs are covered by existing standards. The report discusses specific gaps in coverage on pages 25-32. The full report, as well as a one-page summary and an accessible version can be accessed here. The Department of Health and Human Services, which houses CMS, has concurred with GAO’s recommendations.

ANCOR is currently analyzing the report. ANCOR’s insider intelligence right now is that CMS has no plans to mandate a single assessment, but is planning on issuing additional guidance on conflict of interest later this year.