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State Auditor Issues $74,500 in Findings of Undocumented Medicaid Payments
More than $142,000 in Findings Against Provider Since August
Columbus – Continuing documentation failures for Medicaid-provided oxygen service are putting both patient health and taxpayer dollars at risk, said Auditor of State Dave Yost today. Yost made his comments in response to an audit of Lincare, Inc., a national Medicaid provider specializing in durable medical equipment, including oxygen equipment.
“Certification of need is an essential step for both patient health and taxpayer value,” Yost said. “Proper documentation is not busywork, it is basic work, and it must be done.”
The audit released today included more than $74,500 in findings against the Franklin County location of Lincare, Inc., which operates throughout Ohio. Lincare was found to owe the Ohio Department of Job and Family Services $74,551.42 in Medicaid reimbursements, including interest.
The findings result from non-compliance with Medicaid reimbursement rules for oxygen services. Oxygen services require physician approval by means of certificates of medical necessity, similar to prescriptions. The audit found Lincare provided incomplete or missing certificates and failed to document medical evaluation of patients prior to the prescription of oxygen services.
The audit reviewed Medicaid reimbursements filed by Lincare from Nov. 1, 2007 to Oct. 29, 2009. During this time, the provider was reimbursed $236,742.45. Recoverable findings were calculated at $64,993.00, with accrued interest in the amount of $9,558.42.
The audit released today is the fourth audit of Lincare since August to include findings for reimbursements in violation of applicable requirements. Findings in the amount of $14,154.56 were issued at the Summit County business under the name America’s Best Medical Equipment in August; in the amount of $45,269.53 were issued at the Ashtabula County location in September; and $8,832.31 at the Licking County location in October.
A full copy of this audit can be found online.
The Auditor of State’s office, one of five independently elected statewide 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.