Taylor: Audit Shows Springfield Medicaid Provider Owes Ohio More Than $309,000

Tuesday, May 18, 2010

Clark County - Auditor of State Mary Taylor today released the audit of Quality Care Transport, LTD, a Springfield-based Medicaid provider.  The audit identified $309,336.33 in Medicaid reimbursements repayable to the Ohio Department of Job and Family Services (ODJFS) due to 467 errors in billing documentation.

 “Medicaid providers who fail to comply with state regulations must be held accountable for the misuse of public monies,” Taylor said.  “My office will continue to work to make sure taxpayer dollars are spent legally and appropriately and as the law requires.”

The audit reviewed Medicaid reimbursements filed by Quality Care Transport between July 1, 2004 and March 31, 2007.  According to the report, the ambulance and ambulette service provider failed to accurately document patient transports.  This resulted in $254,045 in findings and $55,291.33 in accrued interest that the transportation provider must repay to ODJFS, the designated state agency that administers Ohio’s Medicaid program.

The majority of documentation errors involved incomplete and invalid Certificates of Medical Necessity (CMN), the transportation equivalent of a doctor’s prescription that ensures transports are provided only for a medically necessary purpose.  Other documentation errors included:

  • Billing for mileage greater than 50 miles without appropriate justification.
  • Billing for mileage greater than was supported in transport records.
  • Billing with missing or incomplete requisite trip documentation.
In addition to billing documentation errors, the audit identified four matters for attention, or noncompliance issues that could result in future monetary findings.  In particular, the audit found that Quality Care Transport improperly altered CMNs, billed Medicaid for services potentially covered by Medicare, failed to indicate third party insurance and lacked patient certification on ambulette CMNs.

A review of employee personnel files also revealed that some Quality Care Transport employees lacked criminal background checks and/or periodic driving record reviews.  While this did not result in a monetary finding, failure to comply with this regulation could place patients in harm’s way and jeopardize Quality Care Transport’s status with the Medicaid program.

The complete audit report is available online.


The Ohio Auditor of State’s office is a leader in the accounting and auditing field, earning prestigious national honors from the Government Finance Officers Association, the National White Collar Crime Center and the National State Auditors Association.

Julia Debes
Deputy Press Secretary
(614) 644-1111