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Butler County Medicaid Provider Owes Ohio Medicaid $72,100
Columbus – Universal Transportation Systems, LLC (Butler County), formerly known as Winton Transportation, LLC, employed eight drivers with lapses in first aid and/or CPR certification and billed for transports that were not covered by the Medicaid program or for transports that did not occur, according to an audit released today by Auditor of State Dave Yost.
“Documentation is a crucial part of the process – both for the recipient of care and for the taxpayer,” Auditor Yost said. “Without complete records, it is unknown if the proper services occurred.”
Auditors reviewed 1,275 paid transports provided during the period of January 1, 2010 through December 31, 2012 and identified 1,155 errors, which resulted in overpayments totaling $66,408.28. With interest in the amount of $5,788.89, Universal Transportation Systems, LLC owes the Ohio Department of Medicaid $72,197.17, according to the report.
The audit identified 248 transports in which the certificates of medical necessity (CMN) did not certify that the recipients met any criteria for an ambulette transport, did not include a medical condition that necessitated the level of transport, and/or were not signed by an authorized practitioner. Auditors also noted 126 paid transports in which there were no CMNs to cover the transport. Additionally, auditors identified CMNs for 604 transports that included medical conditions and were signed by authorized practitioners, but were not complete.
Auditors also tested trip documentation and identified 89 errors, which include:
- 72 transports where the recipients were not transported to a Medicaid covered service, or due to incomplete trip documentation, it could not be determined that the transport was to a Medicaid covered service;
- 9 transports with no service documentation;
- 5 transports where the service documentation was marked “no show”; and
- 3 transports where the service documentation was marked “cancelled,” but the required documentation was not provided.
In addition, a review of the personnel files for 11 drivers identified 8 drivers with lapses in first aid and/or CPR training, ranging from approximately 10 days to 7 months. These drivers were ineligible to provide services during the periods of the lapses.
A full copy of this audit may be accessed online.
The Auditor of State’s office, one of five independently elected statewide offices in Ohio, is responsible for auditing more than 5,800 state and local government agencies. Under the direction of Auditor Dave Yost, the office also provides financial services to local governments, investigates and prevents fraud in public agencies and promotes transparency in government.