Auditors: Company owes $1.5M Medicaid repayment

(The Center Square) – A southern Ohio mental health and addiction services provider needs to repay nearly $1.5 million after an audit showed three years ‘ worth of improper Medicaid payments.

Ohio Auditor Keith Faber said Jay Hash LCC – which does business as HopeSource in Portsmouth – received more than $1.3 million in improper payments. With interest, the total repayment recommended by state auditors is almost $1.5 million.

According to a release, HopeSource is certified by the Ohio Department of Mental Health and Addiction Services in Scioto County and was paid about $9.9 million for 102,000 substance use services.

However, auditors found several reimbursement issues with the company, including documentation and billing practices that didn’t comply with Medicaid requirements.

Also, services provided were not authorized by treatment plans or prior authorization was not received, and unbillable items were included in documented services, auditors said.

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HopeSource disputed the state’s “determination that certain activities included in partial hospitalization services are not billable and the validity of the statistical sampling and extrapolation methodology. (Auditors) reviewed the criteria and our methodologies and maintain that our results and recommendations are valid.”

The Ohio Department of Medicaid or the Ohio Attorney General’s Office is ultimately responsible to take action against the company.

The Ohio Department of Medicaid administers health care and other programs to about 2.9 million lower-income residents, older adults, individuals with disabilities, pregnant women, infants, children and others.

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