CDS compliance · Missouri
Compliance and program integrity
Communicare Elite administers public funds on behalf of people who depend on them. That carries obligations — to MO HealthNet, to the participants we serve, and to the attendants we employ. This section sets out what those obligations are and how we meet them.
It is written to be read by the people it affects, not only by auditors. If something here is unclear, call us and ask.
The areas we are accountable for
Medicaid program integrity
What counts as fraud, waste and abuse in CDS, how to report it, and the protections for people who do.
HIPAA and privacy
How participant health information is used, disclosed, safeguarded, and what rights participants hold over it.
Electronic visit verification
The federal 21st Century Cures Act requirement, what EVV records, and what it deliberately does not.
Background screening
The Family Care Safety Registry and criminal history screening that attendants must clear before working.
Abuse and neglect reporting
Recognizing abuse, neglect, exploitation and self-neglect, and the duty to report it in Missouri.
Grievances and appeals
How to complain about us, and how to appeal a state decision about your services.
Non-discrimination and language access
Civil rights obligations, accessible communication, and free interpretation.
Participant rights
What participants are entitled to, and what the program asks of them in return.
Where do you report fraud, abuse or neglect in Missouri CDS?
Something about our conduct: call us or email info@communicareelite.com.
Suspected abuse, neglect or exploitation of an adult: Missouri Adult Abuse and Neglect Hotline, 1-800-392-0210, 24 hours a day.
Suspected Medicaid fraud: Missouri Medicaid Audit and Compliance, or the Missouri Attorney General’s Medicaid Fraud Control Unit.
Immediate danger: call 911.
You may report anonymously, and we do not retaliate against anyone who reports a concern in good faith.
Why a small vendor publishes this at all
Compliance pages are usually written for regulators and hidden in a footer. That is a mistake in this program, because in Consumer Directed Services the people most likely to breach the rules are not the vendor’s staff — they are participants and attendants who do not know where the lines are.
A daughter caring for her father signs a timesheet for a week she was mostly there. An attendant fills in Friday’s visits from memory on Sunday. Neither of them thinks of it as fraud, and both have just made a false claim against Medicaid with their own signature on it. Publishing these rules where people can actually read them prevents more harm than any internal policy binder.
How does Communicare Elite prevent Medicaid fraud?
- We verify before we pay. Timesheets are checked against the authorized care plan and the electronic visit verification record, not simply processed.
- We train both sides. Fraud, abuse and reporting duties are covered in attendant orientation and in consumer orientation, not buried in a handbook.
- We investigate rather than absorb. A discrepancy gets looked into, even when paying it would be easier and quieter.
- We cooperate fully with MMAC, DHSS and law enforcement reviews and audits, and we keep the records that make cooperation possible.
- We do not retaliate. Nobody who raises a concern in good faith loses services, loses work, or gets treated differently for it.
- We say no. If something is not allowed, we tell you before it becomes a repayment demand — including when saying yes would be easier.
What should you do if you made a timesheet mistake?
Call us today rather than hoping it goes unnoticed. An error you disclose and correct is a fundamentally different situation from one discovered in an audit eighteen months later — in how it is characterized, in what it costs, and in what happens to you. This is the single most useful sentence on this page.
Frequently asked questions
Can I report a concern anonymously?
Yes. You may report anonymously, whether the concern is about our conduct, a timesheet or suspected fraud. Communicare Elite does not retaliate against anyone who reports a concern in good faith. Nobody who raises a concern loses services, loses work or gets treated differently for it. Call us at (314) 809-6655 or email info@communicareelite.com.
What number do I call to report abuse or neglect of an adult in Missouri?
Call the Missouri Adult Abuse and Neglect Hotline at 1-800-392-0210. It is open 24 hours a day and takes reports of suspected abuse, neglect or exploitation of an adult. If someone is in immediate danger, call 911. Our attendant and consumer orientations both cover how to recognize abuse and neglect and when to report it.
Who investigates Medicaid fraud in Missouri?
Suspected Medicaid fraud goes to Missouri Medicaid Audit and Compliance (MMAC) or to the Missouri Attorney General’s Medicaid Fraud Control Unit. You can also tell us first. We cooperate fully with MMAC, DHSS and law enforcement reviews and audits, and we keep the records that make that cooperation possible.
Can a family caregiver commit Medicaid fraud by accident?
Yes. A daughter caring for her father signs a timesheet for a week she was mostly there. An attendant fills in Friday’s visits from memory on Sunday. Neither thinks of it as fraud, yet both have made a false claim against Medicaid with their own signature on it. If you think you have made a mistake, call us today.