Unresponsive Medicaid Provider Owes 3 Years’ Worth of Payments
Columbus – 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.
Christa Miller, a licensed practical nurse, ignored repeated attempts by state auditors to obtain service records needed to back up her Medicaid claims. Miller was paid $358,284 for 2,486 services from July 2013 through June 2016.
State law requires Medicaid providers to maintain complete service records and make them readily available for inspection.
“All Medicaid providers sign an agreement acknowledging their pledge of accountability,” Auditor Yost said. “I can only guess why this provider chose to bury her head in the sand instead of answering to taxpayers.”
Using the contact information on file with the Ohio Department of Medicaid (ODM), auditors fruitlessly reached out to Miller about 10 times by mail, email and phone over a span of three months.
In a final attempt to contact her, an employee from the Auditor’s office drove to Miller’s home in mid-December and spoke to a family member who answered the door, saying that Miller was at work. The employee left his business card and asked the family member to tell Miller to contact the office. She never did.
Auditors labeled the full amount reimbursed to Miller an overpayment because they could not substantiate any of her Medicaid claims. With interest, she owes ODM $378,642.
ODM informed the Auditor’s office that it plans to terminate Miller’s provider agreement. Records show she became a Medicaid provider in September 2010.
A full copy of the report is available online.
The Auditor of State’s office, one of five independently elected statewide offices in Ohio, is responsible for auditing more than 5,900 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.