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Wheelchair Express, LLC Owes Ohio Medicaid $163,100
Columbus – Wheelchair Express, LLC (Franklin County) had no qualified drivers and billed Ohio Medicaid for attendant services that were never provided, according to an audit released today by Auditor of State Dave Yost.
“The rules are in place for the safety of patients and for the protection of tax dollars,” Auditor Yost said. “This owner failed to follow the rules, which put patients at risk and taxpayers on the hook for services that were never provided.”
The audit determined that Wheelchair Express, LLC was overpaid by Ohio Medicaid for services rendered between January 1, 2010 and December 31, 2012 in the amount of $150,192. The overpayment is the total amount reimbursed for all services paid on or after July 1, 2010. With interest in the amount of $12,945.32, Wheelchair Express, LLC owes the Ohio Department of Medicaid $163,137.32.
A review of trip documentation found that the owner served as the driver for more than 97 percent of the trips. Auditors determined that the owner failed to complete a physician statement and controlled substance test in a timely manner. The physician statement was completed six months after the start of the examination period and the controlled substance test was not completed until after the end of the examination period. The owner also had no documentation of alcohol testing and no first aid or CPR certification during the period of April 1, 2010 to June 10, 2011. Additionally, the owner’s son served as a driver during a two-month period in 2010, but there was no evidence that he met any driver qualifications.
In addition, auditors found that the provider did not employ any attendants, but billed for attendant services when a family member or friend of the patient rode in the ambulette. During the examination period, the provider billed and was paid for 604 attendant services that were not provided.
Auditors also noted 1,780 instances in which there were no Certificates of Medical Necessity (CMNs) to authorize the transport and 154 services in which the CMNs were not valid. Additionally, auditors identified 10 transports with CMNs that were valid but incomplete.
Testing of trip documentation identified 219 exceptions, which include:
- 123 transports with no service documentation;
- 63 transports in which the mileage reimbursed was not supported by the documentation; and
- 33 transports in which the recipient was not transported to a Medicaid-covered service or, due to incomplete or conflicting trip documentation, it could not be determined if the transport was to a Medicaid-covered service.
Auditors also noted 569 transports with incomplete documentation. The incomplete documents did not contain the full name or the complete address of the covered Medicaid service and/or documentation for return transports did not contain the drop-off time.
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.