Assisted living made an appearance Thursday at a House of Representatives committee hearing on the Medicaid program when a Government Accountability Office report related to the industry was referenced in the written testimony of a witness.

Carolyn L. Yocom, a healthcare director at the GAO, focused her comments to members of the Committee on Oversight and Government Reform’s Government Operations and Intergovernmental Affairs subcommittees on opportunities to improve oversight of the Medicaid program as part of the hearing’s overall topic of improper payments in the program.

Improper payments across all federal programs have cost taxpayers an estimated $1.2 trillion since 2003, according to background information provided by the committee. The Department of Health and Human Services accounts for two-thirds of all federal improper payments, and the Medicaid program specifically contributes to approximately $36 billion of those improper payments, the committee said.

“Due to concerns about the adequacy of oversight, Medicaid has been on our list of high-risk programs since 2003,” Yocom said.

Three broad areas “critical” to improving Medicaid oversight, she added, include addressing data challenges, strengthening federal oversight, and improving and expanding federal and state collaboration.

These areas were evident in recommendations that the GAO made in January in a report titled “Medicaid Assisted Living Services: Improved Federal Oversight of Beneficiary Health and Welfare is Needed.” In that report, the GAO recommended that the Centers for Medicare & Medicaid Services:

  • Provide guidance and clarify requirements regarding the monitoring and reporting of deficiencies that states using home- and community-based services waivers are required to report on their annual reports;
  • Establish standard Medicaid reporting requirements for all states to annually report key information on critical incidents, considering, at a minimum, the type of critical incidents involving Medicaid beneficiaries, and the type of residential facilities, including assisted living facilities, where critical incidents occurred; and
  • Ensure that all states submit annual reports for HCBS waivers on time as required.

The report was one of several Yocom cited in an appendix in her written testimony. As of March, the recommendations had not been implemented, she wrote.

Watch the subcommittee hearing below; Yocum’s testimony begins at approximately 38:22.