Audit: Firm overbilled Medicaid $592,355

6/16/2007

Toledo's Brookeside Ambulette submitted transportation claims for dead patients, billed for canceled trips, and received other improper Medicaid reimbursements for a total of $592,355 in a three-year period - or almost half what it had received, the state's auditor says.

But it doesn't appear the transportation service for people who use wheelchairs was trying to defraud the state, Ohio Auditor Mary Taylor said during a news conference yesterday at Government Center.

Still, Ohio Attorney General Marc Dann's office, which received the audit this week, will assess whether any criminal charges will be filed against Brookeside, said Brian Laliberte, chief deputy for the office's criminal division.

The state attorney general's office had looked at preliminary findings of Brookeside's audit last year and found no criminal concerns, but the final report is troubling, he said yesterday.

"We are going to take a very close look at Auditor Taylor's findings," Mr. Laliberte said.

Brookeside owner Howard Schnabel did not return calls seeking comment yesterday. Earlier this week, he said Brookeside disputed the audit's findings and would pursue legal recourse.

During an audit of Brookeside's Medicaid billings from July 1, 2002, to June 30, 2005, the state auditor's office found the service improperly billed Medicaid for almost half of the nearly $1.3 million it had received in payments, according to the auditor's office.

Plus, the audit uncovered several instances where Brookeside did not comply with state laws on criminal background checks, proper drug screenings, safety checks, and other requirements for drivers and vehicles, it said.

Brookeside also owes the state $83,680 in interest, an amount that started increasing yesterday by nearly $134 a day and will continue accruing until the total is repaid, the auditor's office said.

The Ohio Department of Job and Family Services, which administers the state's Medicaid program, will make a final decision about recovering the money from Brookeside. The transportation service will be allowed to have an administrative hearing with that department, said Cynthia Callender, director of the fraud and investigative audit group in the auditor's office.

Brookeside didn't have an adequate billing system in place, Ms. Taylor said. "This is basically a breakdown in internal controls," she added.

While the service hasn't agreed to repay more than $676,000 already owed to the state, it submitted a correction plan in February, auditor officials said.

"Obviously, we take our job seriously, protecting Ohio taxpayer dollars," Ms. Taylor said.

Brookeside previously was audited by the state, which found the transportation service was overpaid more than $39,000 from 1996 to 1999.

- Julie M. McKinnon