Taylor Audit Exposes $60,000 Owed to State by Medicaid Provider

Wednesday, February 20, 2008

Columbus -

Auditor of State Mary Taylor today released the Medicaid provider audit of Regency Manor Rehabilitation.  The audit reveals that the long-term care provider owes the Ohio Department of Job and Family Services (ODJFS) $58,540.97 for improperly billed Medicaid services and $2,674.35 for accrued interest. 

“Medicaid providers in the state must be held accountable for the public money they spend.  These funds should be protected by rigorous checks and balances to prevent mistakes in the future,” Taylor said. 

The audit reviewed Medicaid services billed to ODJFS from July 1, 2004 through June 30, 2005.  The audit reveals that Regency Manor Rehabilitation improperly billed Medicaid $40,437.50 for patient room and board services and $18,103.47 for therapy services.  As a result, the provider now owes ODJFS $58,540.97 for billing errors. 

Taylor has referred the findings to ODJFS, which is responsible for adjudicating any findings the provider feels are inaccurate or have already been repaid.  Further, as the state agency charged with administering the Medicaid program in Ohio, ODJFS will make the final determination regarding recovery of the findings once adjudicated. 

The provider did not supply a written response for inclusion in the final audit report but has communicated its plans to work with ODJFS regarding the audit findings.  Additionally, ODJFS recently established a direct billing process which should help Medicaid providers avoid billing mistakes.

In 2005, Taylor sponsored legislation in the Ohio House of Representatives granting the State Auditor discretionary authority to audit individual Medicaid providers.  Medicaid provides health coverage to families with low incomes, children, pregnant women, and people who are aged, blind or have disabilities. 

A full copy of the report is available online at http://www.auditor.state.oh.us/AuditSearch/Reports/2008/A_8_Regency_Manor_Final_Report_to_COB.pdf.