Oversight of Personal Care Services: Key Considerations for Health Plans

Date: October 10, 2013
Time to read: less than a 1 minute.

Health plans increasingly will be required to provide oversight to a broader range of services as more states contract with health plans for managed long-term services and supports. Oversight often refers to preventing fraud and abuse, which requires ensuring that the services being billed are actually provided. Beyond this minimum, oversight also involves monitoring service quality, and ultimately, coordinating services to support members’ goals for maintaining independence and living in the community. Providing oversight of personal care services delivered by direct service workers (DSWs) is often a new activity for health plans. This brief highlights considerations for developing personal care service oversight mechanisms