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Franklin County Medicaid Providers Owe Combined $1.5 Million
Columbus – 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.
The reviews of One Drop Medical Transportation, LLC and Amandacare, Inc. found a total of 1,204 errors, resulting in Medicaid overpayments of $739,961 and $766,970, respectively. The examinations covered the period of July 1, 2011 through June 30, 2014.
One Drop Medical Transportation, LLC, an ambulette company, owes the entire amount reimbursed by the Ohio Department of Medicaid (ODM) during the period because none of its nine drivers tested were qualified to provide services.
Among the disqualifying offenses were five drivers that did not have valid driver’s licenses and one driver with two disqualifying convictions. Several others failed to meet requirements such as obtaining CPR and first aid certification, completing background checks and drug tests and providing driving records. None of the drivers tested completed an alcohol test or provided a physician’s statement, which ensures they are free of impairments that could jeopardize the welfare of patients.
Auditors also found 310 errors with the provider’s trip documentation, including 141 transports that lacked service documentation. Incomplete documentation for another 135 services made it impossible to determine if the transports were made to Medicaid-covered services.
The examination of Amandacare, Inc., a home health provider, found that 22 of the 32 personal care aides tested lacked first aid certification, while six of the 10 that did meet the requirement had lapses in the certification at some point during the review period.
“A transportation company with no qualified drivers and an aide service with barely any certified aides – this sounds like the set-up for a bad joke,” Auditor Yost said. “These providers won’t have the last laugh, though. I expect them to return every dollar owed to the state.”
Additionally, 35 errors were found in Amandacare, Inc.’s service documentation, including 21 instances where forms were not signed by recipients or an authorized representative. Auditors also found no service documentation to support eight services rendered.
Among 29 errors discovered during a review of service authorization, auditors found eight services with claims for reimbursement that were submitted before obtaining approved plans of care. Additionally, two services were provided after receipt of a verbal order to discontinue services.
With interest in the amounts of $41,838 and $27,112, One Drop Medical Transportation, LLC and Amandacare, Inc. owe ODM $781,799 and $794,082, respectively, for a total of $1,575,881.
Full copies of these reports are 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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