(The Center Square) – A southeast Ohio health care provider received nearly $1.3 million in improper Medicaid payments over two years, according to a recent audit.
State Auditor Keith Faber said Tuesday mental health and addiction service provider CRN Healthcare Inc. received the payments among $8.9 million in managed care and fee-for-service payments it received for nearly 140,000 services in fiscal years 2020 and 2021.
CRN Healthcare is a certified Ohio Department of Mental Health and Addiction Services provider.
With interest, Faber said the company should repay $1.4 million for the July 1, 2019 to June 30, 2021 audit period.
“Our examination disclosed that, in a material number of instances, CRN had no service documentation to support the payment and the service documentation, when present, did not include the name of the rendering practitioner and/or the time of day or duration. In addition, there was material non-compliance as CRN lacked treatment plans and, when present, the treatment plans were not signed,” the audit read.
The company said it had bought a new electronic medical records system that it believes will fix the noncompliance issues. It told auditors it closed all officers in early March because of financial problems and another agency assumed client services.
Faber said at the close of compliance, CRN still had one officer in Centerville, where the owners were the sole practitioner servicing three middle schools.
The audit found that no documentation was available to support 44% of the payments that were tested and claims that exceeded billing limitations.
The Ohio Department of Medicaid and the Ohio Attorney General’s Office can ultimately take action to gain compliance and recoup any payments.
