Medicaid examinations by state auditors find nearly $10.7 million in overpayments

The Jackson County Times-Journal

Compliance examinations to verify whether Medicaid providers have sufficient documentation to support payment have led to repayment demands totaling nearly $10.6 million in 2017, Auditor of State Dave Yost announced recently.

Since taking office, Yost’s Medicaid team has identified $35,693,483 in improper payments. In recent years, auditors have focused on home health care billings, reviewing whether staff that performed services on Ohio’s most needy was properly trained and certified, if the services were properly authorized and whether there was supporting documentation to justify payments.

Auditor Yost announced a Franklin County Medicaid provider owes the state $378,642 for three years’ worth of payments because she failed to provide any documentation to support nearly 2,500 services billed to the state. A week earlier (Dec. 21), Auditor Yost announced an Ashtabula County Medicaid provider owes more than $119,000 because she had no documentation to support her billings, claiming she threw them all away after a death in the family.

“Ohioans on Medicaid are our most vulnerable people, and we must protect them as well as the interests of taxpayers,” Auditor Yost said. “Accountability is what you accept when you provide Medicaid services.”

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