Compliance Audit Identifies $1.8 Million-plus in Improper Medicaid Payments and Interest to Lucas County Medicaid Service Provider

COLUMBUS — State auditors identified more than $1.75 million in improper Medicaid payments over a three-year period to a Lucas County behavioral health agency, Auditor of State Keith Faber announced Tuesday.

With added interest, the Auditor of State’s Office is recommending repayment of about $1.87 million from Empowered for Excellence Behavioral Health of Ohio as part of a recently completed compliance examination.

The Ohio Department of Medicaid administers health care and related programming to about 2.9 million lower-income residents, older adults, individuals with disabilities, pregnant women, infants and children, and others.

The Auditor of State, as allowed in statute and pursuant to an agreement with the Ohio Department of Medicaid, audits Ohio’s Medicaid providers to determine if those examined are in compliance with federal and state reimbursement requirements.

The Department of Medicaid and/or the Ohio Attorney General’s Office ultimately take action to gain compliance and recoup any inappropriate or excess payments.

Empowered for Excellence is an Ohio Department of Mental Health and Addiction Services certified agency that was paid $14.9 million to provide 114,800 substance use disorder, mental health, and professional medical services between Jan. 1, 2021, and Dec. 31, 2023.

Issues identified in Tuesday’s compliance audit included instances where treatment plans did not authorize services that were provided, missing documentation to support reimbursements, and services exceeding daily limitations, among other issues.

The full report is available online at ohioauditor.gov/auditsearch/search.aspx.

Empowered for Excellence’s response to the findings is included in the audit report.

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The Auditor of State’s Office, one of five independently elected statewide offices in Ohio, is responsible for auditing more than 5,900 state and local government agencies. Under the direction of Auditor Keith Faber, the office also provides financial services to local governments, investigates and prevents fraud in public agencies, and promotes transparency in government.

Public Affairs

Contact: Marc Kovac

press@ohioauditor.gov