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Audit of Medicaid Provider Triggers More Than $100,000 in Findings for Recovery
Columbus - More than $86,000 in undocumented Medicaid charges, along with $15,233.96 in accrued interest, added up to $102,223.96 in findings for recovery issued in the audit of reimbursements made to Michael Linville, LPN, released today by Auditor of State Dave Yost.
“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 scope of this audit of Linville was limited to claims for which he provided services to Ohio Medicaid patients and received payment during the period of July 1, 2006 to June 30, 2009.
In two separate samplings of Linville’s home care nursing services, auditors identified $5,124.99 and $81,865 in findings owed to the Ohio Department of Job and Family Services for services reported, but not properly documented. For example, Linville failed to provide nursing notes and patient plans of care authorizing him to provide services.
Accrued interest of $15,223.97 was added to the findings through September 29, 2011. After September 29, 2011, additional interest will accrue at the rate of $19.07 per day until the findings and interest are paid in full to the Ohio Department of Job and Family Services.
The Auditor of State’s office performs audits of Medicaid providers to ensure compliance with reimbursement rules and to confirm that services billed to Ohio Medicaid are properly documented and consistent with professional standards of care, medical necessity, and sound fiscal, business, or medical practices.
A full copy of this audit can be found online.
The Auditor of State’s office, one of five independently elected offices in Ohio, is responsible for auditing more than 5,600 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.