Objective

To determine the extent of implementation of the recommendation made in our initial audit report, Improper Medicaid Payments to a Transportation Provider (Report 2018-S-10).

About the Program

The State’s Medicaid program provides transportation to medically necessary services for recipients who are unable to obtain transportation on their own. Medicaid providers are required to maintain contemporaneous, complete, acceptable, and verifiable records necessary to support Medicaid payments for a period of six years. If the information is incomplete, unacceptable, or false, any Medicaid payments will be recouped and the provider may be subject to other statutory or regulatory liability, financial damages, and sanctions.

We issued our initial audit report on September 5, 2018. The audit objective was to determine whether Medicaid made inappropriate payments to a transportation provider. The audit covered the period September 26, 2012 through December 31, 2016. The audit found that a transportation provider did not maintain the required documentation to support transportation claims prior to 2016, which accounted for $1.4 million in Medicaid payments. We recommended that the Department of Health (Department) recover improper payments made to the Medicaid provider.

Key Finding

Department officials made some progress in addressing the problem we identified in the initial report. The Office of the Medicaid Inspector General opened an investigation into the provider; however, the investigation remained ongoing at the time of our follow-up review. The initial report’s one recommendation had been partially implemented.

Key Recommendation

Officials are given 30 days after the issuance of the follow-up report to provide information on any actions that are planned to address the unresolved issues discussed in this report.