Taylor Identifies Medicaid Provider Owes State Nearly $700,000

Friday, June 15, 2007

Toledo -

Auditor of State Mary Taylor released the Brookeside Ambulette audit today.  The audit findings reported that the transportation provider for wheelchair bound individuals owes the Ohio Department of Job and Family Services (ODJFS) $592,355.15 for improperly billed Medicaid services and $83,680.31 for accrued interest. 

“Inappropriate use of taxpayer dollars is a serious matter that can open the door to fraud, theft and abuse,” said Taylor.  “Medicaid providers in the state must be held accountable for the money they spend.  Proper documentation and rigorous checks and balances should be the rule, not the exception.”

Auditors reviewed Medicaid services billed to ODJFS from July 1, 2002 through June 30, 2005. During the examined time period, Brookeside received a total of $1,281,671.45 in Medicaid payments. 

Results of the audit include:

  • Duplicate claims
  • Overpayments
  • Claims submitted for cancelled trips
  • Claims for patients who did not require wheelchair transportation
  • Claims with missing or incomplete justification for Medicaid services
  • Claims submitted for deceased patients
  • Improperly billed mileage

Auditors also noted several instances of Brookeside’s failure to comply with state laws regarding driver and vehicle requirements such as:

  • Criminal background checks and proper drug screenings
  • CPR or EMT training
  • Annual vehicle safety checks

The audit includes an official response from Brookeside addressing the findings of the audit. On February 18, 2007, the provider submitted a corrective action plan to address concerns raised in the audit including designating an employee to verify all claims submitted for Medicaid reimbursement and maintaining proper travel logs.

This is the second review of payments made to Brookeside Ambulette conducted by the State Auditor’s office. The first audit released on August 23, 2000, identified $39,132.71 in overpayments made to the provider from January 1, 1996 to December 31, 1999. Brookeside received a total of $626,879.25 in Medicaid payments over that same period. 

During the audit period, Brookeside Ambulette had northwest Ohio dispatch locations in Toledo, Bryan and Defiance.  The Bryan and Defiance locations are now closed.  According to the Ohio Medical Transportation Board, 257 companies currently offer ambulette transportation services in the state of Ohio, many of whom serve as Medicaid providers.

In 2005, Taylor sponsored legislation in the Ohio House of Representatives granting the State Auditor discretionary authority to audit individual Medicaid providers.  Medicaid provides health coverage to families with low incomes, children, pregnant women, and people who are aged, blind, or have disabilities.  Medicaid is administered by ODJFS.

The Ohio Auditor of State’s Office is one of the largest accounting offices in the nation.  The office strives to ensure that all public funds are spent legally and appropriately and works aggressively to root out fraud, waste and abuse in public spending. Taylor encourages anyone suspecting fraud or misspending of public dollars to contact her office toll free at 1-866-FRAUD-OH (1-866-372-8364).

A copy of the full audit is available online at http://www.auditor.state.oh.us/AuditSearch/Reports/2007/Brookeside_Ambulette_Lucas_Final_Report.pdf.