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Taylor Report Indicates Medicaid Provider May Owe State More Than $500,000
Scioto County -
Auditor of State Mary Taylor today released the Medicaid provider audit of a Scioto County medical equipment supplier. The audit of Advanced Medical Concepts, Inc. of Wheelersburg, Ohio indicates the provider incorrectly billed the Ohio Department of Job and Family Services (ODJFS) approximately $420,000. An additional $82,000 in accrued interest is also outstanding.
“Medicaid providers in Ohio must be held accountable for the public funds they spend,” Taylor said. “The failure to do so increases the potential for misspending or fraud and could jeopardize the funding of a program serving some of the state’s most vulnerable citizens.”
The total amount Advanced Medical Concepts may owe the state, including interest, is $501,975.81. The audit reveals that certain claims filed by Advanced Medical Concepts for reimbursement contained billing errors. The errors include:
- Claims for oxygen services billed incorrectly
- Potentially altered documentation supporting some claims
- Claims billed for more than the amount Medicaid allows
- Duplicate claims
- Claims billed for services on dates after a patient had died
The audit reviewed Medicaid reimbursements made to Advanced Medical Concepts from October 1, 2002 through September 30, 2005. During this period, the provider was reimbursed $2,874,251.28 for 14,364 Medicaid services billed on 12,614 claims.
Taylor has referred the findings to ODJFS. As the state agency charged with administering the Medicaid program in Ohio, it is the responsibility of ODJFS to make any final determinations regarding recovery.
A copy of the complete report is available online at www.auditor.state.oh.us.
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). Since taking office in January 2007, Taylor has identified more than $11.4 million in public funds that were handled improperly, spent illegally or stolen and must be repaid.