Columbus–Medicaid provider Total Home Health Care (Franklin County) owes the state more than $1.6 million for unauthorized or undocumented charges for home health services, according to an audit released today by Auditor of State Dave Yost.
The provider failed to provide documentation for 107 services and another 146 services were not appropriately authorized, adequately documented, or provided by qualified individuals.
“The bigger the risk of loss in a program, the more care is needed to prevent it,” Auditor Yost said. “Medicaid rules are clear: No paperwork, no payment.”
Total Home Health Care was paid approximately $4.1 million for nearly 90,000 instances of service for either personal care aide (such as bathing) or home health aid (such as administration of medication). Additional sums for services other than home aides were also charged to Medicaid, but were not the basis for any recommended findings for recovery.
The Auditor of State’s office performs audits of Medicaid providers to ensure compliance with reimbursement rules and to confirm that services billed to Ohio Medicaid are properly documented and consistent with professional standards of care, medical necessity, and sound fiscal, business, or medical practices.
A full copy of this audit can be found online.
The Auditor of State is one of five independently elected statewide offices under the Ohio Constitution. Auditor Yost’s office is responsible for auditing over 5,600 state and local government agencies. Staff also works in partnership with state and local governments to deal effectively with financial, accounting and budgetary issues.