Wednesday, August 10, 2016
By KALEA HALL
A local transportation company for Medicaid clients has disputed the state auditor’s finding that it received overpayments.
Ohio Auditor of State Dave Yost’s office performed a Medicaid examination of Angel Carriers of Youngstown this summer and found 785 errors in a sample of 687 transportation services from July 1, 2011, through June 30, 2014, which led to Medicaid overpayments totaling $458,083.
The overpayment amount plus interest of $28,755.69 is equal to $486,838.69 owed to the Ohio Department of Medicaid.
The auditor’s office released the report, dated July 25, on Tuesday.
“Angel Carriers has not sought nor received Medicaid reimbursement for services not rendered or for ineligible clients or ineligible services,” reads a letter to the state auditor’s office from Natalie Riley Rodway, owner of Angel Carriers. “Angel Carriers disputes any overpayment on that basis.”
Angel Carriers, located at 1142 E. Midlothian Blvd. on the city’s South Side, was formed in 2007, according to the Ohio Secretary of State’s website.
The auditor examined Angel Carriers to see if it was in compliance with Medicaid requirements for driver qualifications, service documentations and service authorization for nonemergency medical transportation.
“The Auditor of State’s Office has access to all Medicaid claims, and our auditors run various reports looking at those claims, selecting providers based on their analysis,” said Dominic Binkley, the auditor’s public information officer, in a statement. “For example, if auditors find anomalies during their data mining, they may select that provider for an examination.”
In November 2015, the auditor notified Angel Carriers of its plan to perform a Medicaid compliance examination on the business.
Angel Carriers informed the auditor that a fire that took place in October 2014 at its former location at 5095 Market St. in Boardman destroyed some or all of its records.
The records had fire and water damage and were left in filing cabinets and were not removed before the demolition of the building, according to the auditor’s report.
“After auditors issued a draft report identifying the entire amount reimbursed by Ohio Medicaid as an overpayment due to a lack of supporting documentation, the provider said it did have the records,” the auditor’s office said in a statement.
In the report, the company notes its loss/damage of records from the fire.
“Many of the records that were examined were blackened with soot, a fact which was not mentioned in the report,” Rodway said.
“Angel Carriers is committed to providing the much-needed transportation services to Medicaid eligible clients and continues to work to ensure compliance with Medicaid regulation and improve maintenance of records,” she added.
The examination found that 15 drivers hired during the examination period did not complete a required alcohol test; 14 of those drivers had either no background checks or completed them after the provisional hiring period; and 10 out of 20 drivers tested failed to obtain both first aid and CPR certification.
“Any Medicaid provider that entrusts the lives of patients to unqualified employees is playing with fire,” Yost said in a statement. “Patients and their families should always feel confident in their provider’s abilities.”
An additional three dozen other incidents were found where the drivers were lacking necessary training or certification.
In total, 131 transports were provided by ineligible drivers, the auditors found. Auditors also found 252 errors in trip documentation and 288 transports that lacked Certificates of Medical Necessity, CMN, and 46 trips with CMNs that did not certify that recipients met any criteria for medical necessity.
The auditor’s office refers its findings to the Ohio Department of Medicaid for further action.
The department will review the findings and then make a final decision to adopt those findings, a spokeswoman said, adding Angel Carriers will be sent a notice alerting it of its rights, including a request for a hearing, if the auditor’s findings are adopted.
Angel Carriers did not return a request for additional comment outside of the owner’s response to the auditor in the auditor’s report.