Columbus –A Franklin County home health agency owes the state more than $2 million, primarily because the company billed the Ohio Department of Medicaid (ODM) for services it was not yet authorized to provide. 

America’s Home Health Services, a Columbus-based provider, was reimbursed $4.59 million by the Ohio Medicaid program from July 2013 through June 2016 for providing home health and personal care aide services. State auditors determined $1.98 million of the amount was an overpayment based on 1,229 errors in a sample of 2,073 services. With interest, the company owes $2.13 million.

A sample of 1,554 home health care services revealed that 615 (40 percent) were ineligible for reimbursement because the company billed the state before obtaining required authorization from a physician. 

“This practice of ‘bill the state first, get approval later’ is wholly irresponsible – and prohibited,” Auditor Yost said. “It puts patients at risk for improper care and forces taxpayers to pay for services that might not be necessary.” 

Auditors also reported that all nine personal care aides included in the review were unqualified because they lacked first aid certification. According to the report, the company was unaware of the requirement. All 519 personal care aide services tested were administered by unqualified employees. 

In another finding, auditors cited 60 instances where a personal care aide signed her name on service records as both the care provider and the patient. 

A special report released by Auditor Yost in February details the costs and dangers of noncompliance in Ohio’s Medicaid program. Legislation introduced in the fall with the support of Auditor Yost aims to curb these risks with tougher safeguards for high-risk providers. 

A full copy of the America’s Home Health Services 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 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.

Contact:
Beth Gianforcaro
Press Secretary
614-644-1111