Ohio’s state auditors have uncovered a substantial discrepancy in Medicaid payments made to Lucas County-based behavioral health services provider Caregiver Grove Behavioral Health LLC. An announced report by Auditor of State Keith Faber indicates that improper Medicaid payments amounting to $1.75 million were made to the provider over two years. The state recommends that Caregiver Grove repay approximately $1.96 million, including the accrued interest on the improper payments and the Ohio Auditor of State’s website details.
The audit stemmed from a compliance examination in an agreement between the Ohio Department of Medicaid (ODM) and the Auditor of State’s Office. ODM delivers health care to approximately 2.9 million residents, including lower-income families, older adults, and people with disabilities. Within this context, the imperative is to safeguard these funds so they effectively reach those in need.
From January 1, 2020, to December 31, 2022, Caregiver Grove received about $6.2 million for mental health and substance use disorder services. However, the recent report has flagged several inconsistencies. There was an apparent lack of supporting documentation for the billed services. Furthermore, treatment plans were either missing or did not sanction the billed services for individual and group therapy sessions, among other billing infractions…