Columbus – State auditors found that a Hamilton County provider of home health and personal care aid services improperly billed the state for more than $1 million in work was ineligible for payment from the Ohio Department of Medicaid.

An examination of Affinity Healthcare solutions by Auditor of State Keith Faber’s office found a number of problems with the company’s service records, which should have disqualified it from receiving $1,003,070 of state aid. Incurring interest, the company owes the Department of Medicaid $1,070,481.

“All Medicaid providers sign an agreement acknowledging their pledge of accountability,” Auditor Faber said. “It is abundantly clear that this provider did not abide by that pledge.”

Upon reviewing each of the services provided by Afinity, some of the errors auditors found included:

·       749 compliance errors in a sample of personal care aide services totaling $611,282 in improper payments.

·       238 compliance errors in a sample of home health aide services totaling $118,971 in improper payments.

·       219 compliance errors in a sample of home health nursing and private duty services totaling $57,113 in improper payments.

·       37 of 70 personal care aides that were tested did not meet minimum qualifications on their first aid certifications.

The examination also states, “Material non-compliance with aides that did not meet the qualifications to render waiver aide services; with services billed for what the provider lacked supporting documentation, with units billed that exceeded documented duration, and with home health services that were not authorized as they lacked plans of care.”

In their official response, Afintiy disputed the findings because of the use of statistical sampling. Upon evaluating their response, the Auditor’s office determined that the findings were valid and accurate.

A full copy of this report is available online.

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The Auditor of State’s office, one of five independently elected statewide offices in Ohio is responsible for auditing more than 6,000 state and local government agencies. Under the direction of Auditor Keith Faber, the office also provides financial services to local governments, investigates and prevents fraud in public agencies, and promotes transparency in government. 

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Allie Dumski

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