Missouri Medicaid Audit and Compliance (MMAC) conducts post-payment reviews (audits) of Medicaid-enrolled providers’ billing. As a service to our enrolled providers, MMAC wishes to remind providers of several requirements, and the regulatory language that provides instruction to providers.
Requirements are slightly different for “individual worker delivery records” (in-home services) and “time-sheets” (Consumer Directed Services). Both are commonly referred to as time-sheets. There is no standard required time-sheet for either program, but there are certain requirements. Requirements for in-home services are found at 19 CSR 15-7.021 (24)(A) and those for CDS are found at 19 CSR 15-8. These sections cover the requirements for signatures, dates of service, in and out times, and documenting tasks performed.
13 CSR 70-91.010 covers the requirements for Separately Authorized Nurses Visits, and the required documentation. The authorized nurse visit services must include one or more specified services, and the documentation shall include written notes and observations.
13 CSR 70-3.030 contains valuable information that can assist providers with their billing procedures. The regulation reminds providers to take reasonable measures to review claims for payment for accuracy, duplication, or other errors caused or committed by employees when the failure allows material errors in billing to occur (13 CSR 70-030(3)(A)(31).
Employee background screening requirements may vary slightly among different programs, and it is important for providers to conduct background screenings appropriately. The following regulation sections describe requirements for providers ensuring aides are registered with the Family Care Safety Registry (FCSR), that screenings are done at the time of hire, and when a Good Cause Waiver must be requested. Background screening requirements for in-home services aides are found at 19 CSR 15-7.021 (4) (A) 4 and 19 CSR 15-7.021 (19) (G) and for CDS attendants, they are found at 19 CSR 15-8.400 (4) (A) 1.