DHSS suspends A Loving Care PCA
DHSS has determined that a credible allegation of fraud exists against A Loving Care PCA (ALCPCA), a personal care and waiver service provider and suspended Medicaid payments to the agency. As of 5/30/14, ALCPCA is no longer able to bill Medicaid for PCA and waiver services.
The Department of Health and Social Services (DHSS) has determined that a credible allegation of fraud exists against A Loving Care PCA (ALCPCA), a personal care and waiver service provider. Therefore, DHSS has suspended Medicaid payments to ALCPCA. As of 5/30/14, ALCPCA is no longer able to bill Medicaid for PCA and waiver services.
What happens to recipients?
Medicaid recipients authorized to receive personal care and/or waiver services from ALCPCA will be informed of ALCPCA’s suspension by mail. In the event that ALCPCA ceases to provide services, SDS will provide recipients with a list of providers certified to provide PCA and/or waiver services.
Recipients that have care coordinators may need their assistance to transfer to agencies that can bill Medicaid. SDS will expedite service authorizations for those recipients receiving transfers. Please remember that recipients must be offered a choice in providers and provider solicitation of recipients is never authorized.
Can Individual PCAs employed by ALCPCA continue to provide services?
Yes, they may provide personal care services but cannot be paid by ALCPCA through Medicaid funds.
An individual PCA must be hired by a different PCA agency and obtain background check clearance before being paid by Medicaid for PCA services. To ensure a smooth transition for PCAs, the Background Check Unit will expedite the background check clearance process for those PCAs transferring from ALCPCA.
DHSS is striving to ensure that Medicaid recipients are not adversely affected by the suspension of payment to ALCPCA. If you have questions, please contact Pat Walker, SDS Quality Assurance Manager at firstname.lastname@example.org.