The auditors found noevidence of fraud or abuse.
By STEPHEN SIFF
VINDICATOR TRUMBULL STAFF
MINERAL RIDGE -- No paperwork, no money.
Lane Life Trans has been told to return $250,000 it was paid by Medicaid for transporting hundreds of patients in the company's wheelchair vans between Jan. 1, 1996, to June 30, 2000.
The reason: Although the service may have been warranted, Lane did not hang onto written proof that a doctor said so.
"There were no allegations of fraud or abuse or anything like that," said Joe Lane, the ambulance company's chief executive officer. Auditors found no problems with how they provided or billed for their services, "except for that piece of paper," he added.
When a state audit of the company began in October, Lane officials told auditors they did not routinely collect the doctor's order, called a physician certificate.
"The physician certificate is analogous to a physician's order or a prescription," auditors wrote in a report released Tuesday. "Just as a prescription is required in order for a pharmacy to dispense medications and must be maintained as a record kept by the pharmacy, the physician certificate for transportation services is that document that validates the medical necessity to transport the patient and must be maintained as a record by the transportation provider."
The audit dealt entirely with the company's transportation service for wheelchair-bound patients, Lane said. The company also provides emergency medical service in a number of local communities, including Weathersfield, McDonald, Mineral Ridge, Canfield and Austintown.
Explanations: Several explanations for the record keeping lapse were presented in the auditor's report: the company didn't know that it needed to keep the certificates; it relied on the outside company that handled its billing to tell Lane what records to keep; and necessity of medical transport could still be verified from other sources and medical records.
Lane said he does not think the requirement was put into effect until after the start of the audit period. The company intends to contest the finding to the next level -- the Ohio Attorney General's office, he said.
As part of their investigation, auditors tried to follow up with 10 patients whose care had been billed to Medicaid. One had died, and another had no telephone. Auditors found that of the eight who could be reached, all needed and were eligible for the services they received.