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Pickaway County Medicaid Provider Owes $1.3 Million
Columbus – AccentCare Home Health of California, Inc. (Pickaway County) employed 15 personal care aides with no first aid certification and billed for services that lacked supporting documentation, according to an audit released today by Auditor of State Dave Yost.
“Medicaid providers have duties to both their patients and taxpayers,” Auditor Yost said. “When providers don’t follow the rules – nobody wins.”
A statistical sample of 1,603 services provided during the period of July 1, 2008 through June 30, 2011 identified 416 errors, which resulted in overpayments totaling $1,202,598.31. With interest in the amount of $150,876.67, AccentCare Home Health of California, Inc. owes the Ohio Department of Medicaid $1,353,474.98.
Auditors tested 19 aides for provider qualifications and found that of 16 aides that rendered personal care aide services, 15 were ineligible to render services because they had no first aid certification. Additionally, one aide was ineligible for a portion of the examination period because the individual provided services prior to obtaining first aid certification.
Auditors also tested for compliance with annual training requirements and found that three aides had completed little training, making them ineligible for the years in which they did not complete the required training. One of the aides had only one continuing education topic noted in a four-year period, and two aides did not complete 12 training topics in at least two of the four years tested.
The statistical sample of services also found 101 personal care aide services in which the service documentation was not signed by the recipient or an authorized representative. Auditors also noted 68 services that had no supporting documentation, 9 services in which the units reimbursed did not agree with the units on the service documentation, and 3 services in which documentation did not include tasks performed.
In addition, the audit reviewed the plans of care in effect for 545 home health aide services and noted 21 services in which the plan of care was not signed and/or dated by a physician, 2 services in which the plan of care did not authorize home health aide services, and 1 service in which there was no plan of care. Auditors also found instances where plans of care were invalid because they were dated after the certification period and after the services were billed.
A full copy of this report may be accessed online.