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Office of Program Policy Analysis and Government Accountability

MAXIMUS’s Prior Service Authorization Process Meets Contract Requirements, But Improvements Are Needed, Report No. 06-17, February 2006
 
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  • The Agency for Persons with Disabilities has contracted with MAXIMUS, Inc., to perform prior service authorization reviews for Home and Community-Based Services Waiver clients.  These reviews are intended to ensure that requested services are medically necessary and that their duration and scope are within established service limitations.
  • MAXIMUS has met contractual requirements for employing qualified staff and has implemented procedures to help assure that its staff are making consistent determinations.  However, there is insufficient communication between MAXIMUS reviewers and waiver support coordinators regarding the reviewers’ concerns with client support and cost plans.  The agency’s notices regarding the fair hearing process do not inform clients and their guardians regarding the quasi-judicial nature of the fair hearing process for appealing MAXIMUS’s determinations.  Stake-holders expressed concern that the fair hearings process is unnecessarily adversarial and intimidating.  

Which Government Program Summaries contain related information?

Agency for Persons with Disabilities

What other OPPAGA-related materials are available?

  • Report No. 14-09 iBudget Implementation Continues as the Agency for Persons with Disabilities Responds to Legal Challenges,published in March 2014.
  • Report No. 08-49 Agency for Persons with Disabilities Has Made Several Changes to the Prior Service Authorization Process, published in August 2008.
  • Report No. 08-15 APD Should Take Steps to Ensure New Needs Assessment and Individual Budget Process Is Timely and Effective, published in March 2008.
  • Report No. 06-54 APD Waiting List Should Be Improved for Agency’s Planning and Budgeting Purposes,  published in July 2006.
  • Report No. 05-39 OPPAGA Report: Disabilities Groups Should Improve Coordination, But Duplication of Activities Appears to Be Low, published in July 2005.
  • Report No. 05-14 OPPAGA Report: Vocational Rehabilitation Program’s Performance Has Been Mixed Since the Abolishment of Occupational Access and Opportunity Commission, published in March 2005.

Copies of this report in print or alternate accessible format may be obtained by telephone (850/488-0021), by FAX (850/487-9213), in person, or by mail (OPPAGA Report Production, Claude Pepper Building, Room 312, 111 W. Madison St., Tallahassee, FL 32399-1475).
e-mail address: oppaga@oppaga.fl.gov


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