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Medicaid Examinations by State Auditors Find Nearly $10.7 Million in Overpayments in 2017
Medicaid Effort Part of Auditor Yost’s Culture of Accountability
Columbus – 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 today.
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.
Today, 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.”
The improper Medicaid billings are just part of the culture of accountability Yost has emphasized as state Auditor.
“We are the last line of defense for Ohioans, and it’s a duty everyone in this office takes very seriously. Accountability is woven into the fabric of the office, and I’m proud of the work we’ve done to protect taxpayer dollars and to hold people accountable,” Yost said.
For calendar year 2017:
• Work by the Public Integrity Assurance Team led to the convictions of 21 people and the indictments of nine others in 2017. The current year’s convictions bring to 140 the number of convictions since 2011 when Yost’s first term began.
Of the 2017 convictions, the most notable was that of Mt. Sterling administrator Joseph Johnson, who was charged with 30 felonies for stealing more than $700,000 from the Madison County village. He was sentenced to 10 years in prison and ordered to make restitution. Others in the small community were indicted and convicted in conjunction with the Auditor of State’s probe.
Of the 2017 indictments, the 101-count indictment of Youngstown-area developer Dominic Marchionda was the largest. Marchionda’s charges are related to alleged corrupt activity, theft, and money laundering related to three development projects with the City of Youngstown.
The success of the Public Integrity unit has led to a jump in the number of complaints it received. In the past three years, the office has averaged 638 complaints annually. In 2011, there were 417 complaints, an increase of 53 percent.
• Auditors uncovered $3.1 million in improper or undocumented spending by local governments in 2017 and issued findings for recovery (FFR) in that amount. In addition, FFRs totaling $465,335 were issued against charter schools in Ohio during the past year, for a total of $11.1 million since Auditor Yost’s first term began.
“The reforms we pushed for in House Bill 2 have helped improve accountability in our community schools. We would not have had the type of claw back of funds at ECOT and other schools without it,” Yost said of the legislation signed into law in 2015.
• More than 1,100 people received training from a cybersecurity expert in the Auditor of State’s office. The expert, Nicole Beckwith, led training in 16 sessions across the state that attracted mainly those with a law enforcement background. So popular were the sessions that Auditor Yost asked that additional trainings be held across the state in 2018 and also directed staff to create a webinar based on the training to allow all local governments and the public the opportunity to learn how to hamper hackers. The webinar will be available in 2018.
“Governments are becoming increasingly popular targets among cybercreeps who want to wreak havoc on our government and personal bank accounts,” Auditor Yost said. “Our staff has created an informative, impressive program to help people – inside and outside government – understand the high-risk areas, and this webinar will help reduce that risk.”
• The office issued a series of ‘Best Practice’ reports with guidance for local officials to guard against credit card abuse, payroll fraud and theft of funds that are paid to local governments but stolen instead of being deposited in the government bank accounts. Research by the Auditor’s staff found that credit card abuse totaled $1.2 million since 2011 and $3.4 million in missing or stolen payments in the past decade.
• The Ohio Performance Team (OPT) released 17 performance audits in 2017 with recommended savings totaling more than $28.5 million. That brings the total recommended savings to $261 through 133 performance audits since 2011 when Yost became Auditor.
“Our mission is clear: Protect tax dollars,” Auditor Yost said. “We do that by holding local officials accountable for the dollars they spend, by helping safeguard their systems from criminals and helping them spend less through our performance auditing. By any measure, 2017 was a success for the office.”
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.