State auditor: Dayton-area home health provider owes almost $4M

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State auditor: Dayton-area home health provider owes almost $4M

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Ohio Auditor Dave Yost

A home health provider based in Washington Twp. owes the state nearly $4 million after state auditors unearthed widespread noncompliance among staff who worked directly with patients, according to the Ohio auditor.

But an attorney representing Healing Touch Health Care Ltd. said Tuesday the state used “complicated math” to show millions of dollars in Medicaid overpayments from a small number of billing errors and imperfect paperwork.

“There are some cases where there is no service provided at all, but that’s not the case here,” said Laura Perkovic, a Westerville attorney. “That’s not what the audit shows. The audit shows form over substance errors. There is a mathematical formula that was used to extrapolate a few thousand dollars worth of billing errors into a few million.”

Healing Touch Health Care Ltd. claimed $8.5 million in Medicaid reimbursement from the state from 2013 through 2015, but state auditors determined $3.7 million of that amount was an overpayment – the second largest amount in a Medicaid examination since 2011.

The office found 783 errors during testing of 1,500 services administered by the company during the review period. With interest, the provider owes the state over $3.9 million, according to the auditor.

Auditors found six of 11 aides lacked first aid certification and the remaining five had lapses during the review period. Due to the extent of the noncompliance, the review was expanded to include an additional 37 aides who provided services.

“Trust is the most important factor when picking a care provider for a loved one,” Ohio Auditor Dave Yost said. “How can anyone trust a company that lets over 90 percent of its personal care aides care for patients without the required certification?”

Auditors determined that 16 of the 37 employees had no first aid certification and another 17 had lapses. In total, 106 of 154, or 69 percent, of personal care services tested were administered by one of the 44 employees who were ineligible on the dates of service.

In a June 29 letter to the auditor’s office from Perkovic and another Chapman Law Group attorney, Healing Touch Health Care claimed, subsequent to the audit, valid first aid certifications were found for 24 home health aides and additional records supported some previously undocumented services. The company also questioned the auditor’s application of Medicare regulations regarding signed orders from doctors. The company asked for the overall amount owed to be recalculated.

Healing Touch Health Care “has made every attempt to comply in good faith with all Medicaid regulations,” the company’s attorneys wrote.

RELATED: State audit faults Dayton for missing deadlines, accounting errors

Healing Touch Home Healthcare at 7031 Corporate Way opened in 2004 and offers home health services, including skilled nursing, wound care and catheter, tracheotomy and ostomy assistance among others, according to the company’s website.

The state auditor issues about 25 Medicaid reports a year, all of which are turned over to the Ohio Attorney General, according to an auditor’s office spokesman. After an examination, the auditor’s office calculates any findings for recovery and issues a draft report. The draft is sent to providers for any documentation or to correct misunderstandings. Following review, the office issues a final report, which often includes findings for recovery.

Perkovic said the result of such cases range from a return of funds to the Department of Medicaid to civil and criminal lawsuits — sometimes more than one.

“Based on the allegations, it’s hard to conceive this case will amount to anything besides fighting over how much money to pay back,” she said.

Calls to Healing Touch owners seeking comment were not returned.

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