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Medicaid provider lacked documentation to support $157,109 in reimbursements
Columbus – A Medicaid provider based in Scioto County failed to submit any documentation to support $157,109 in reimbursements she received from the Ohio Department of Medicaid (ODM), according to a report released today by Auditor of State Dave Yost.
Bessie Haskins billed ODM $157,109 for 1,714 personal care aide services allegedly provided from 2012 through 2014. Auditors made numerous attempts to notify Haskins of the examination but only received a response after she was sent a draft report identifying 100 percent of the reimbursements as an overpayment.
Haskins then contacted the Auditor’s office to schedule a review of documentation, but subsequently requested a later date to allow her additional time to obtain and organize her records. Just before that date arrived, Haskins informed auditors that she was unable to obtain the required documentation.
“State law requires all Medicaid providers to maintain complete documentation and present it for review,” Auditor Yost said. “I guess this provider didn’t read the memo.”
Without the necessary records, auditors could not review the provider’s compliance with requirements for provider qualifications, service authorization and service documentation. As a result, auditors identified $157,109 – the entire amount reimbursed by ODM during the period – as an overpayment. With $5,604 in interest, the provider owes the department $162,713.
A full copy of this report is available online.
The Auditor of State’s office, one of five independently elected statewide offices in Ohio, is responsible for auditing more than 5,900 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.
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