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Summit County Medicaid Provider Owes Ohio Medicaid $167,200
Columbus – A to B Transportation, LLC (Summit County) employed a driver with no driver’s license and no first aid or CPR certifications, according to an audit released today by Auditor of State Dave Yost.
“Job requirement number one for a driver is a valid driver’s license,” Auditor Yost said. “Without any of the proper qualifications, this person never should have gotten behind the wheel, let alone step foot in an ambulette.”
Auditors reviewed 234 ambulette transportation services provided during the period of January 1, 2011 through December 31, 2013 and identified 177 exceptions, which resulted in overpayments totaling $158,770. Additionally, auditors reviewed 100 ambulette transportation services billed as cancelled trips and identified 10 exceptions that resulted in overpayments totaling $278.90. With interest in the amount of $8,242.22, A to B Transportation, LLC owes the Ohio Department of Medicaid $167,291.12, according to the report.
Auditors reviewed the personnel files for all three drivers that rendered transportation services during the examination period. One driver failed to provide a driving record, had no first aid or CPR certification and no driver’s license for a 15-month period. In addition, the driver provided transportation services for one year before completing the required passenger assistance training. The audit also determined that a second driver had no signed physician statement and the driving record was not obtained until 55 days after the date of hire. A third driver had an 18-month lapse in first aid certification and a 2-month lapse in CPR certification.
The audit also identified 45 transports in which the certificates of medical necessity (CMN) did not certify that the recipients met any criteria for an ambulette transport, did not include a medical condition that necessitated the level of transport, and/or were not signed by an authorized practitioner. Auditors also noted one paid transport in which there was no CMN to cover the transport. Additionally, auditors identified CMNs for 36 transports that included medical conditions and were signed by authorized practitioners, but were not complete.
Auditors also tested trip documentation and identified 11 exceptions, which include:
- 6 transports with no service documentation;
- 2 transports with no driver identified on the service documentation;
- 1 transport with no address listed for the pick-up location; and
- 2 transports where the mileage reimbursed was not supported by the documentation.
A full copy of this report 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.