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Medicaid Provider Lacked Supporting Documentation for Hundreds of Services
Columbus – A Medicaid examination released today by Auditor of State Dave Yost uncovered more than $82,000 in overpayments to a Summit County provider who lacked documentation to support hundreds of services she billed to the state.
Bovkisha Lee, a personal care aide, was paid $176,611 by the Ohio Department of Medicaid (ODM) from 2013 through 2015. The review determined that $82,661 of the amount was an overpayment based on 816 errors found in a sample of 828 services. With interest, Lee owes ODM $89,003.
Much of the overpayment amount stemmed from an absence of supporting documentation for 424 of the 828 services tested.
“Nonexistent service documentation warrants a nonexistent payment,” Auditor Yost said. “Without complete records, we have no proof that more than half of the services examined ever occurred.”
Available records for an additional four services listed overlapping service times for multiple recipients on the same days.
A separate finding revealed that Lee provided 74 services during a five-month lapse in her first aid certification during 2013 and another two-month lapse in 2015.
According to the report, Lee cared for seven patients during the review period. For one of those individuals, Lee never obtained authorization to administer services. Lee was authorized in October 2014 to provide services to a separate recipient, but she had already been caring for that individual since at least July 2013.
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.