For Immediate Release:                                                      

May 6, 2021                                                                        

Improper Payments Identified in Exam of Lima-Urban Minority Alcoholism and Drug Abuse Outreach Program

Columbus – Auditor of State Keith Faber’s Office released a Medicaid compliance examination of the Lima-Urban Minority Alcoholism and Drug Abuse Outreach Program (UMADAOP). The examination found improper payments totaling over $36,000 during a six month period in 2018. The examination focused on case management, intensive outpatient program and medially monitored intensive inpatient treatment services.

While the purpose of an examinations is to render an opinion on compliance, in this case the auditors noted concerns with the authenticity and validity of Lima-UMADAOP’s service documentation and were unable to render an opinion. Examples of the concerns with the authenticity of the documentation include: 

• Documents for the same service but with different practitioners and distinctly different observations of the recipient;
• Multiple instances in which a document included a recipient name but the narrative reflected the name of a different recipient; and
• Documents for services for the same recipient with overlapping times and different practitioners and both documents indicated the recipient was present.

Auditors did compare the agency’s documentation to the Medicaid requirements for a total of 636 services and noted 307 instances of non-compliance in these services.  Examples of the errors include:

• Services rendered by unqualified practitioners (either during a gap in their certification and having no certification)

• Overbilled units (duration) of services;
• Lack of service documentation to support the payment; and
• Lack of treatment plan to authorize services.

In total, auditors found that 45 percent of the services tested did not meet Medicaid requirements and identified an improper payment of $36,235.89 for these services. With interest, $39,288.14 is due to the Ohio Department of Medicaid.

In its response to the examination, Lima-UMADAOP outlined steps to address the results including a change in its electronic health records system, closer monitoring of staff qualifications and stronger monitoring through clinical and medical supervision.

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.