The Able Americans policy report outlines six critical reforms to combat fraud, waste, and abuse within Medicaid’s Home- and Community-Based Services (HCBS) program, which supports 8.4 million Americans with disabilities at a fraction of the cost of institutional care. To safeguard this flexible funding without penalizing vulnerable families, the authors recommend creating public transparency dashboards, increasing CMS oversight on state spending, and establishing data-driven fraud detection. Additionally, the proposal advocates for empowering recipients to direct and verify their own care, measuring outcomes based on service delivery, and ensuring strict integrity and ownership disclosures from third-party providers.

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