WEBVTT

00:00:00.000 --> 00:00:04.839
A closed Medicaid system is an audit hypothesis, not a finding. Test five record sets.

00:00:04.839 --> 00:00:09.679
One: the current provider directory and what each family received before selection.

00:00:09.679 --> 00:00:14.518
Two: referral distributions across qualified willing providers, regions, services, and time.

00:00:14.518 --> 00:00:19.358
Three: person-centered plans, authorizations, claims, and provider-choice records.

00:00:19.358 --> 00:00:24.197
Four: institutional delays compared with available community capacity and each person's preferences.

00:00:24.197 --> 00:00:29.037
Five: contractor contracts, communications, grievances, accommodation decisions, and audit logs.

00:00:29.037 --> 00:00:33.876
Medicaid rules protect choice among qualified willing providers, subject to lawful exceptions.

00:00:33.876 --> 00:00:38.715
HCBS rules require informed choices and integrated settings.

00:00:38.715 --> 00:00:43.555
Concentrated referrals, missing records, or payment anomalies justify review; they do not prove steering, bias, retaliation, or fraud.

00:00:43.555 --> 00:00:48.394
Read the source-linked framework at david-medeiros.com.