Franklin County Medicaid Provider Owes Ohio Medicaid $139,655
Columbus – 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.
“You complete the paperwork and then send the bill – not the other way around,” Auditor Yost said. “Without a physician’s approval beforehand, there’s no proof that the services billed for were needed.”
Auditors reviewed 516 services provided during the period February 20, 2013 through June 30, 2014 and identified 162 exceptions, which resulted in overpayments totaling $132,785.80. With interest in the amount of $6,869.39, Tashay 1 Home Healthcare, Inc. owes the Ohio Department of Medicaid $139,655.19.
The audit identified 97 services provided in which the plans of care were signed by a physician after the services were rendered and after the provider had billed and was reimbursed by Ohio Medicaid.
In addition, testing of aid qualifications found the following errors:
- 3 aides rendered personal care aide services with no first aid certification;
- 3 aides had incomplete competency evaluations;
- 1 aide had no documentation that a registered nurse observed and evaluated him/her for the competency evaluation; and
- 4 aides had competency evaluations that were completed after rendering services, ranging from 3 days to 15 months after the first dates of service.
Auditors determined that eight of the 18 aides tested were ineligible to render services during a portion of the examination period. The audit identified a total of 59 services rendered by aides that did not meet provider qualifications on the dates of service.
In addition, a review of service documentation identified nine services with no supporting documentation. The audit also noted one instance in which the units billed did not match documentation.
A full copy of this report 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.
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