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Cuyahoga County Medicaid Provider Owes $35,000
Columbus – An independent Medicaid provider falsely claimed that services were rendered by a doctor, according to an audit released today by Auditor of State Dave Yost.
“He took advantage of the system,” Auditor Yost said. “These types of Medicaid services must be provided in association with a present and consenting physician – no exceptions.”
Auditors tested 112 services provided over a three year period by Able Counseling & Associates, Inc. and determined that all were overpayments. With interest in the amount of $2,002.33, Able Counseling & Associates, Inc. owes the Ohio Department of Medicaid $35,366.92.
Able Oriri, owner and operator of the company, is a Licensed Professional Clinical Counselor (LPCC). Oriri used a Medicaid number assigned to Dr. Edward Dutton to bill Ohio Medicaid for services rendered by a physician. When contacted by auditors, Dr. Dutton stated that he has no business relationship with Oriri and that no one has permission to use his Medicaid number.
Medicaid laws require services performed by an LPCC to be under the general supervision of a physician and may only be billed by, and reimbursed to, the employing or contracting physician or clinic. Oriri was not employed by, or under contract with, a physician or clinic during the examination period and did not perform services under the general supervision of a physician.
On October 14, 2014 the provider’s articles of incorporation were cancelled due to a failure to file a biennial report of Professional Corporation.
A full copy of this audit 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.