Mahoning County Medicaid Provider Owes $486,838
Columbus – A Medicaid examination of Angel Carriers LLC (Mahoning County) found the provider was ineligible to receive reimbursement for 99 percent of services tested from July 2011 through June 2014.
The report released today by Auditor of State Dave Yost notes 785 errors in a sample of 687 transportation services provided, which resulted in overpayments totaling $458,083 – 97.5 percent of the total amount reimbursed by the Ohio Department of Medicaid (ODM) during the period. With $28,756 in interest, the provider owes ODM $486,839.
Auditors initially contacted the provider on Nov. 5, 2015 to begin the examination, but were told the required records were destroyed by a fire. However, auditors determined the fire was limited to a garage and was not in the office where records were stored. After auditors issued a draft report identifying the entire amount reimbursed by Ohio Medicaid as an overpayment due to a lack of supporting documentation, the provider said it did have the records.
A review of personnel documents found that 15 drivers hired during the examination period failed to complete a required alcohol test, 14 of whom either had no background checks or completed them after the provisional hiring period. Additionally, 10 out of the total 20 drivers tested failed to obtain both first aid and CPR certification.
“Any Medicaid provider that entrusts the lives of patients to unqualified employees is playing with fire,” Auditor Yost said. “Patients and their families should always feel confident in their provider’s abilities.”
Auditors identified more than three dozen other instances where drivers either lacked required training, certification, drug testing or physicians statements, or obtained them after the hiring period. As a result, auditors concluded that 13 drivers were ineligible during the entire examination period and five were ineligible until they completed all hiring and certification requirements. A total of 131 transports were provided by ineligible drivers.
In addition, auditors discovered 252 errors in trip documentation, including 116 transports with no supporting trip documentation. Auditors also found 288 transports that lacked Certificates of Medical Necessity (CMN) and 46 with CMNs that did not certify that recipients met any criteria for medical necessity, did not include a medical condition that necessitated the level of transport, or were not signed by an authorized practitioner.
A full copy of this report is available 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.
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