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Clermont County Medicaid Provider Owes $146,000
Columbus – The former top billing independent nurse in the state’s Medicaid program claimed payment for overlapping services, according to an audit released today by Auditor of State Dave Yost.
“A person cannot be in two places at the same time,” Auditor Yost said. “This nurse’s claims scream of fraud.”
Auditors reviewed a total of 998 services claimed by Patricia Fugate and identified 198 services with instances of noncompliance. Fugate’s clinical notes showed overlaps of 112 services, claiming different patients in different locations received treatment at the same time.
Other instances of noncompliance included:
- 34 services without proper signatures
- 24 services with no supporting documentation
- 14 services with improper documentation
- 9 services without a valid plan of care
- 4 services billed while the patient was hospitalized
- 1 improperly billed group service
- Combined with $8,358.92 in interest, Fugate owes the Ohio Department of Medicaid (ODM) $146,210.68.
During the three year examination period, Fugate provided 15,548 services to 47 Medicaid recipients and received a total reimbursement of $843,516.54 from ODM. Prior to the release of this report, Fugate’s Medicaid number was suspended.
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.