ADvantage and MSPPC Provider Report Cards
The Department of Human Services (DHS) operates the ADvantage Waiver as approved by the Centers of Medicare & Medicaid Services. One of the Quality Assurance strategies is the annual provider audit for agencies providing services for ADvantage and Medicaid State Plan Personal Care Programs.
DHS Quality Assurance staff collects data by reviewing Member files on-site in provider offices & by interviewing Members by telephone or home visit.
Provider Report Cards
A note about accessing Provider Report Cards:
This tool gives Members, Families & Caregivers the ability to make an informed decision when selecting an agency for the ADvantage and Medicaid State Plan Personal Care Program. However, this does not replace the Member/Family/Caregiver’s duty to make direct contact with the agency, ask questions and use their individual judgment when making this selection.
- Independent Case Management Providers (Under Construction)
- Independent Home Health Providers (Under Construction)
- Medicaid State Plan Personal Care Providers (Under Construction)
Find certified provider agencies by Independent Case Management and Independent Home Care in a specific county.
Plan of Correction
- Providers are required to complete a written Plan of Correction based on their audit results.
Quality Assurance Advisement
- DHS provides educational advisement to provider agencies completing a Plan of Correction.
- A Follow-Up Audit is conducted after the written Plan of Correction and Quality Assurance Advisement
- Effective September 1st, 2013, a provider agency scoring less than 70% on an annual audit is placed in "off referral" status for a minimum of 90 days. During "off referral" status, the provider agency does not receive new program Members; however, services continue for current Members.
- A provider agency resumes "on referral" status after the Follow-Up Audit and a score of 80% or greater.
- A provider agency scoring less than 80% on the Follow-Up Audit remains "off-referral" and is subject to further advisement and a re-audit.