Wednesday, April 04, 2001

Firm owes Medicaid, auditor says

Payment estimated at $358,192

By Susan Vela
The Cincinnati Enquirer

        A Price Hill company owes the state $358,192 for billing Medicaid more than it should have while providing oxygen equipment to 12 area nursing homes, state Auditor Jim Petro said Tuesday.

        A Medicaid review conducted by the state auditor's office demanded that Valley Medical Corp. reimburse the Ohio Department of Job and Family Services, which administers the state's Medicaid program, or risk having the matter turned over to the Ohio Attorney General's Office.

        The company supplies oxygen equipment to nursing facilities that including Meadowbrook Care Center of Montgomery and Riverview Nursing Community of Delhi Township.

        J. Randall Richards, a lawyer for company owner Grover L. Davis, said his client has not done anything wrong and has the documentation to prove it. Mr. Davis will not pay the state until he has been given a hearing before Ohio Medicaid officials, said Mr. Richards.

        “I don't believe (state agencies) have authority to conduct audits of Medicaid providers,” he said. Medicaid is a combined federal and state program for low-income patients.

        The company will challenge the entire overpayment alleged by the auditor's office.

        Kim Norris, spokeswoman for Mr. Petro, said that the agency has been trying to crack down on Medicaid fraud related to medical equipment for some years. Such Medicaid fraud is a problem nationwide, she


        “Any time that we can help insure that the proper reimbursements are taking place, it ultimately saves tax dollars,” she said.

        The agency has been reviewing companies randomly and turned to Valley Medical Corp. in October, she said. For its review, the agency focused on claims filed between Jan. 1, 1997, and June 30, 2000.

        The claims involved oxygen concentrating equipment that comes in the size of small refrigerators. The equipment is responsible for converting a room's air into oxygen.

        According to the report:

        • Valley Medical Corp. charged nursing homes $120 a month for equipment use but asked to be reimbursed $178 by Medicaid.

        • The company improperly asked to be reimbursed for oxygen equipment that hadn't been prescribed by a physician or also asked to be reimbursed for a longer period than had been prescribed.

        Mr. Richards refused the auditor's request for more documents in late February, which prompted the auditor's office to demand reimbursement, the report said.


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