By Holly Zachariah
The Columbus Dispatch (Ohio)
PORTSMOUTH, Ohio — For the second time in two months, Ohio Auditor Mary Taylor has cited an ambulance company for overbilling the state Medicaid system for services.
The first time, it was a company in Fairfield County that had to pay back about $13,000. This time, it is a southern Ohio-based company with a branch in Columbus that the auditor says owes the state $434,443.
Life Ambulance Service Inc., based in Portsmouth in Scioto County, must reimburse the Ohio Department of Job and Family Services $352,663, plus pay nearly $82,000 in interest for services improperly billed from 2003 through March 2006, according to the audit released Thursday.
Life Ambulance provides ambulance services and transportation to clients in wheelchairs. It operates in Cincinnati, Cleveland and Columbus, as well as across southern and southeastern Ohio.
Included in the findings are allegations that the company:
* Submitted claims without any documentation that services were ever provided.
* Billed Medicaid for services that should have been billed to Medicare.
* Submitted the same claims twice and, on six occasions, submitted claims for service for patients who were dead.
* Overcharged mileage.
The errors could be the result of sloppy paperwork and bad management, said Steve Faulkner, Taylor’s spokesman. But he said the agency hasn’t ruled out fraud.
The audit has been forwarded to the state attorney general’s office and to the Medicaid Fraud Control Unit at Job and Family Services.
Life Ambulance’s medical director, Dr. Wayne Wheeler, denied any intentional wrongdoing.
He said the bills in question represent a small fraction of the 240,000 patients the company serves each year and do not signal a widespread problem. Any errors were honest ones, Wheeler said.
The company will request a state hearing and take the matter to court if necessary, he said.
“This audit is part of a fundamentally flawed and unfair process,” Wheeler said. He said the company’s billing was “a pencil and paper system” at the time covered by the audit, and he says that was an accepted industry practice then.
Job and Family Services spokesman Brian Harter said no one was available yesterday to comment on the audit.
The Medicaid system is a tax-funded insurance program for the poor and disabled. It is the Ohio government’s largest program, and Taylor has made investigating its billing practices, particularly at ambulance companies, a priority, Faulkner said.
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