Using Medicaid to Cover Services for Elderly Persons in Residential Care Settings: State Policy Maker and Stakeholder Views in Six States. Paperwork


  • The amount of paperwork involved in accepting CBA waiver clients and the difficulties in dealing with a state agency keep some providers from serving these clients. For example, when a CBA waiver client is involved in an incident in an ALF, the facility has to go through two different report processes, one with the regulatory agency and the other with the CBA waiver program agency.

  • The audit process done by the CBA waiver program, which looks at ledger receipts and daily census record, and the potential fines and vendor/client holds for what are essentially "clerical errors" are a disincentive for some providers to take CBA waiver clients.

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