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Published: Friday, 3/18/2005

Doctor pays back $33,000 to Medicaid

BY STEVE MURPHY
BLADE STAFF WRITER

SANDUSKY - A Sandusky physician has repaid more than $33,000 in Medicaid reimbursement funds in response to a state audit that found he had received payment for medical examinations and procedures without proper documentation.

Dr. William Schlotterer paid $33,553 last month to the Ohio Department of Job and Family Services, days after receiving a finding for recovery from the office of Ohio Auditor Betty Montgomery, according to an audit released yesterday.

The amount repaid was more than three-fourths of the $43,659 Dr. Schlotterer received in Medicaid reimbursements between 2001 and 2003, said Jennifer Detwiler, a spokesman for Ms. Montgomery. "It's significant, to be sure," Ms. Detwiler said.

Auditors reviewed 103 of 543 services for which Dr. Schlotterer received Medicaid funds. Of the number of filings sampled, "We took exception with 99 of them," Ms. Detwiler said.

In many instances, Dr. Schlotterer's notes from patient examinations did not include enough detail to justify the level of reimbursement paid by Medicaid, the audit states. In one such case, the record contained "no notation of a comprehensive history, a history of the current illness, chief complaint, name and/or dosage of any prescriptions written," the audit said.

In another, the physician's notes said a patient had a cough and got a checkup but gave no further explanation. The record also noted a prescription was ordered but gave no information other than the name of the drug.

The audit also found six instances in which medical records "lacked proper documentation to verify that a billable physician service was performed."

In two other instances, Dr. Schlotterer was found to have been reimbursed for obesity treatments, which are not covered under Medicaid.

According to the audit, Dr. Schlotterer told the auditor's office when he repaid the money Feb. 22 that he "planned to no longer participate in the Medicaid program."

A phone recording at the doctor's office staid yesterday he would be out from March 11 to 21. A message left at his Sandusky home was not returned.

The audit was done at the request of the Department of Job and Family Services, the only agency that can legally authorize such a review of a Medicaid provider. A bill pending in the Ohio House of Representatives would allow the auditor's office to initiate Medicaid audits, and Ms. Montgomery thinks the state could recover much more improperly spent money that way, her spokesman said.

"We believe there is a larger pool of misspent dollars ... that we could recover since Medicaid takes up about 40 percent of our state budget," Ms. Detwiler said.

For the fiscal year ending June 30, Ohio is projected to spend $10.6 billion on Medicaid, which covers the poor and the disabled.

Last year, the state recovered $1,098,782 in improper Medicaid spending through 44 audits, up from $900,369 through 25 audits in 2003, Ms. Detwiler said.

Contact Steve Murphy at:

smurphy@theblade.com

or 419-724-6078.



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