Medicaid
For Immediate Release
COLUMBUS – More than 124,000 people enrolled in Ohio’s Medicaid Program were simultaneously enrolled in Medicaid programs in other states, according to a report released Tuesday by Ohio Auditor of State Keith Faber.
For Immediate Release
Columbus – State auditors identified nearly $691,000 in improper Medicaid payments to a Warren County business for durable medical equipment it could not prove was delivered to patients or was otherwise not authorized to provide, Auditor of State Keith Faber announced Tuesday.
State auditors found that a Hamilton County provider of home health and personal care aid services improperly billed the state for more than $1 million in work was ineligible for payment from the Ohio Department of Medicaid.
Overpayment to Richland County Company is Largest Since Auditor Yost Took Office in 2011
A Mansfield-based addiction treatment program owes almost $11 million to the state for services that were unsubstantiated or ineligible for reimbursement from the Ohio Department of Medicaid.
Geographic Price-Spread Disparities Found in Medicaid Pharmacy Payments
Ohio's Pharmacy Benefit Managers (PBMs) charged the state a “spread” of more than 31 percent for generic drugs – nearly four times as much as the previously reported average spread across all drugs, according to a new report by Ohio Auditor of State Dave Yost.
Auditor of State Dave Yost announced today the review by his staff regarding the fees retained by Pharmacy Benefit Managers (PBMs) to handle the state’s pharmacy management will be released to the Joint Medicaid Oversight Committee at its Aug. 16 meeting.
A Stark County provider of behavioral health services billed the state almost $840,000 for services that were ineligible for payment from the Ohio Department of Medicaid (ODM), state auditors found.
A new report by the Ohio Auditor of State’s office shows the number of Ohio Medicaid recipients with an opioid-related diagnosis (dependence, abuse or overdose) climbed 430 percent between 2010 and 2016, with the state now providing assistance to a soaring number of Ohioans addicted to opioids.
A Franklin County home health agency owes the state more than $2 million, primarily because the company billed the Ohio Department of Medicaid (ODM) for services it was not yet authorized to provide.
A Franklin County Medicaid provider that administered some of its care with unqualified staff improperly billed the state for more than $900,000 worth of services, according to a report released today.
Pending Legislation Would Establish Additional Safeguards for State’s High-Risk Medicaid Providers
Medicaid providers who are unqualified or lack records to justify payments for services have repaid only a fraction of the tens of millions of dollars they owe to the state, according to a special report released today by Auditor of State Dave Yost.
A state review of a Scioto County Medicaid provider uncovered almost $128,000 in improper payments stemming from errors in service documentation and a lack of first aid training.
An unresponsive Franklin County Medicaid provider owes the state three years’ worth of Medicaid payments because she failed to provide any documentation to support nearly 2,500 services billed to the state.
Medicaid Effort Part of Auditor Yost’s Culture of Accountability
Compliance examinations to verify whether Medicaid providers have sufficient documentation to support payment have led to repayment demands totaling nearly $10.6 million in 2017, Auditor of State Dave Yost announced today.
An Ashtabula County Medicaid provider owes the state more than $119,000 because she allegedly threw away records needed to support all of the services she was paid for during a three-year period.
A Medicaid examination released today by Auditor of State Dave Yost uncovered more than $82,000 in overpayments to a Summit County provider who lacked documentation to support hundreds of services she billed to the state.
Overpayment to Hamilton County Provider is Second Largest Since Auditor Yost Took Office in 2011
A home health agency in Hamilton County owes the state $4.51 million for Medicaid overpayments and interest stemming, in part, from patient care provided by nearly 80 unqualified employees.
A care facility in Stark County received more than $11,000 in Medicaid reimbursements during 2015 for services that never occurred, state auditors found.
Auditor of State Dave Yost and Sen. Peggy Lehner today announced legislation to stop the kind of Medicaid fraud and overpayments that have cost taxpayers nearly $29 million since 2011 and deprived Medicaid patients of the care those dollars are intended to provide.
Overpayment is Second Largest Since Auditor Yost Took Office
A Dayton home health provider owes the state nearly $4 million after state auditors unearthed widespread noncompliance among staff who worked directly with patients.
A Pickaway County Medicaid provider owes the state nearly $141,000 because it administered home health services with employees who let their first aid certification expire.
Chenita Group Home in Mansfield (Richland County) billed the Ohio Department of Medicaid $9,057 for patient services that never occurred or were not authorized, according to an examination completed by Ohio Auditor Dave Yost.
A Medicaid provider in Cuyahoga County is on the hook for nearly $50,000 after state auditors discovered she billed the state for almost 150 aide services that could not be substantiated.
Several employees of a Medicaid provider in Meigs County administered home health aide services even though they had no first aid certification, according to a report released today by Auditor of State Dave Yost.
The Riverside Local School District’s (Lake County) former billing company erroneously doubled the amount of Medicaid services it billed to the state, contributing to $378,068 in overpayments to the district.
A Medicaid examination by Auditor of State Dave Yost’s office found a provider in Clark County was overpaid by $36,676 from 2012 through 2014.
Unqualified drivers provided dozens of transportation services for a Medicaid company based in Scioto County, contributing to nearly $200,000 in overpayments from the state, auditors found.
Examinations of four northeast Ohio Medicaid providers identified more than $1 million in overpayments this week, according to reports released by Auditor of State Dave Yost.
A Medicaid provider based in Scioto County failed to submit any documentation to support $157,109 in reimbursements she received from the Ohio Department of Medicaid (ODM), according to a report released today by Auditor of State Dave Yost.
A Medicaid transportation company based in Lucas County billed the state for hundreds of services that lacked proper supporting documentation, according to a Medicaid examination released today by Auditor of State Dave Yost.
More than $448,000 in improper Medicaid payments have been made to Integrity Ambulance Service, LLC (Darke County) as a result of transportation services being provided without proper authorization, according to an examination released today by Auditor of State Dave Yost.
Transportation services provided by ineligible drivers and a lack of required documentation contributed to more than $300,000 in Medicaid overpayments to a provider located in Cuyahoga County, according to a report released today by Auditor of State Dave Yost.
A Cuyahoga County ambulette company owes the state $109,668 after a Medicaid examination found incomplete documentation and services provided by unqualified drivers.
A Columbus-based home health agency was overpaid to the tune of $573,000 because it provided services with unqualified aides and billed the state before obtaining proper service authorization.
A Medicaid examination of Great Nursing Care, Inc. (Franklin County) found the home health agency was overpaid $4.9 million because it provided services with unqualified employees and billed for services before obtaining proper authorization.
The overpayment is the largest amount identified in a Medicaid examination since Auditor Yost took office in 2011.
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.
Citywide Incorporated, a Cincinnati Medicaid provider, was overpaid $688,292 for services it provided because it employed unqualified employees, billed for services that were not properly documented, and used the same documentation to bill for multiple claims.
Medicaid examinations of two Franklin County providers identified more than $1.5 million in recoverable findings, according to reports released today by Auditor of State Dave Yost.
Zimam Holdings, LLC, dba Zimam Home Healthcare (Franklin County) provided services with unqualified employees and billed for services before obtaining authorization from a physician, according to an examination released today by Auditor of State Dave Yost.
The Logan-Hocking Local School District (Hocking County) received $25,345 in Medicaid overpayments over a span of three years, according to a Medicaid examination released today by Auditor of State Dave Yost.
Shifo Healthcare Services, LLC (Franklin County) employed aides with no first aid certification, contributing to more than $2.1 million in recoverable findings – the largest amount identified in a Medicaid examination since Auditor of State Dave Yost took office in 2011.
Summit Academy - Youngstown (Mahoning County) billed for services for students who were absent or not even enrolled on the dates of service, according to a Medicaid audit released today by Auditor of State Dave Yost.
Emmanuel Ventures Limited, LLC (Cuyahoga County) failed to maintain original trip documentation and had no qualified drivers, according to an audit released by Auditor of State Dave Yost.
Poor billing controls resulted in more than $22,000 in overpayments to the Milford Exempted Village School District (Clermont County), according to a Medicaid audit released today by Auditor of State Dave Yost.
Tashay 1 Home Healthcare, Inc. (Franklin County) billed for services before obtaining proper authorization and provided services with employees who were unqualified, according to an audit released today by Auditor of State Dave Yost.
Wheelchair Express, LLC (Franklin County) had no qualified drivers and billed Ohio Medicaid for attendant services that were never provided, according to an audit released today by Auditor of State Dave Yost.
Ambulance Service, Inc. (Jefferson County) billed for services that lacked proper documentation and hired two drivers who had no first aid and/or CPR certification prior to rendering services, according to an audit released today by Auditor of State Dave Yost.
A to B Transportation, LLC (Summit County) employed a driver with no driver’s license and no first aid or CPR certifications, according to an audit released today by Auditor of State Dave Yost.
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.
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.
LifeCare Wheelchair Transportation, Inc. (Lorain County) hired a man with a felonious assault conviction -- and 13 employees had lapses in their required first aid and/or CPR certifications that deemed them ineligible for employment -- according to an audit released today by Auditor of State Dave Yost.
Life Safe Security Corporation, a Tennessee-based emergency response service provider, owes the Ohio Department of Medicaid (ODM) more than $25,000.
An independent Medicaid provider falsely claimed that services were rendered by a doctor, according to an audit released today by Auditor of State Dave Yost.
A Franklin County Medicaid provider failed to present required documentation for 75 services, according to an audit released today by Auditor of State Dave Yost.
A Medina County Medicaid provider had no documentation for more than 100 services, according to an audit released today by Auditor of State Dave Yost.
Unqualified drivers, rampant errors and a lack of documentation resulted in Medicaid overpayments on 88 percent of Kentucky-based Action Delivery Service’s total reimbursements from 2009-2011.
A questionable documentation process led Meda-Care Transportation, Inc. (Hamilton County) to improperly bill Ohio Medicaid, contributing to overpayments of more than $160,000.
Yama Transportation (Lucas County) billed Ohio Medicaid for services it could not have provided, according to an audit released today by Auditor of State Dave Yost.
Caretenders of Cleveland, Inc., a Medicare certified home health agency, was overpaid by more than $64,000, according to an audit released today by Auditor of State Dave Yost.
Documentation provided by Medicaid provider Jennifer Jones indicated that she administrated services to multiple patients in different locations at the same time, according to an audit released today by Auditor of State Dave Yost.
Claims of water damage followed by fire damage were made by a Putnam County Medicaid provider who failed to maintain required documentation of service delivery, according to an audit released today by Auditor of State Dave Yost.
A Cuyahoga County based Medicaid provider was overpaid by more than $7,000, according to a 2008-2010 audit released today by Auditor of State Dave Yost.
No response and no documentation left auditors unable to express an opinion regarding licensed practical nurse Candy Cain’s compliance with Medicaid regulations.
No response and no documentation left auditors unable to express an opinion regarding licensed practical nurse Candy Cain’s compliance with Medicaid regulations.
A lack of supporting documentation led auditors to identify an overpayment of more than $155,000.
No response and no documentation left auditors unable to express an opinion regarding former Medicaid provider Sharon Rivera’s compliance with Medicaid regulations, according to an audit released today.
State auditors had to go digging into a basement for records to complete the audit of Cuyahoga County-based Greathouse Medical Transportation, LLC.
Franklin County-based ambulette service Caring Hands Transportation of Ohio, LLC owes Ohio Medicaid $71,000.
The following audits will be released Tuesday, October 1, 2013.
Medicaid patients were driven by unqualified drivers and records were kept in piles on the floor, according to an audit of Cuyahoga County-based ambulette service provider Kafaru Medical Transportation, LLC released today
Franklin County-based ambulette service Angels on Assignment Home Health Agency owes $58,000 to Ohio Medicaid because of inadequate documentation for billed charges.
Doctor Failed to Document Tax-paid Services
Failure to document services cost Toledo-based psychiatrist Bhupinder S. Chahal, M.D. (Lucas County) $24,000 in Ohio Medicaid charge-backs.
An accelerated two-month audit of Tuba Rescue Transportation, a Hamilton County-based Medicaid provider, resulted in the denial of more than $306,000 in services billed for transportation of Ohio Medicaid patients.
Findings Issued Against Healthcare Provider
Insufficient records and care given that was never ordered by a doctor led to more than $195,000 in findings issued in the Medicaid provider audit of Carol S. Sito, LPN, of Ashtabula County.
More than two-thirds of all Medicaid charges by a Cleveland-based ambulette service were not doctor-approved, according to an audit released today by Auditor of State Dave Yost.
More than $142,000 in Findings Against Provider Since August
An audit of Lincare, Inc., a national Medicaid provider specializing in durable medical equipment, including oxygen equipment, included more than $74,500 in findings.
“Medicaid providers are responsible not only for their patients, but also for the tax dollars that flow to them,” Auditor Yost said. “Without a paper trail, questions arise.”
The Ashtabula location of Lincare, Inc., a national supplier of durable medical equipment operating throughout Ohio, was found to owe the Ohio Department of Job and Family Services $45,269.53 in Medicaid reimbursements, including interest