Risk Management Perspective
Policy/Procedure: Policies and procedures need to be up-to-date and meet current guidelines.
Implementation: Ensure all contracts are reviewed and appropriate, including compliance language. Educate staff, residents, and family members regarding appropriate billing processes regarding transportation.
Audit: Periodically perform internal and external audits, including checking the OIG and other exclusion lists. Facility management and senior management should periodically review vendors scheduled and actual billing statements.
Attorney General Barbara D. Underwood announced that a Medicaid medical transportation provider and its president were sentenced for stealing$1.2 million from the Medicaid program. The president of the company was sentenced to three years’ conditional discharge and 150 hours of community service. The company was sentenced to pay a fine of $10,000. As a condition of his plea, the president was also required to pay $900,497 in restitution to the state.
A taxi driver for the company was also sentenced for stealing over $7,500 from the Medicaid program. The driver, 48, was sentenced as a Second Felony Offender to 2 to 4 years in prison with the possibility of parole release supervision. As a condition of his plea, he was required to pay $23,598 in restitution to the state.
