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Home Health Company Owes Ohio Medicaid $713,000
Columbus – Failure to document services, not following doctor-prescribed plans of care, and ineligible family members used as health aides are among more than $713,000 in recommended findings against Franklin County-based provider Jama & Sulub Home Health Care LLC, according to an audit released today by Auditor of State Dave Yost.
“Time sheets show services were delivered, and plans of care tell us what patients need,” Yost said. “When we can’t see those things, there are just too many missing pieces of the puzzle for us to know anyone is entitled to payment with public money.”
The audit examined 303 instances of home health services and found 123 of them to be in error, resulting in overpayment by Ohio Medicaid in the amount of $640,848 between Nov. 1, 2007 and June 30, 2011. With interest of $71,915, the total due is $712,763.
Among the violations were 23 instances of having no timesheets to verify date and duration of provided service, 43 instances of missing plans of care to show that the services were prescribed by doctors, and 24 instances where care was provided by a step-parent or parent, which is not reimbursable under Ohio Medicaid.
The audit also found poor recordkeeping of employee training requirements, but did not issue any recommended findings.
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’s office, one of five independently elected statewide offices in Ohio, is responsible for auditing more than 5,600 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.