State auditors have flagged a Lucas County behavioral health agency, Empowered for Excellence Behavioral Health of Ohio, for more than $1.75 million in improper Medicaid payments, it was announced by Auditor of State Keith Faber on Tuesday. The figure swelled to approximately $1.87 million with added interest, following a comprehensive compliance examination targeting adherence to federal and state reimbursement guidelines.
Within Ohio, Medicaid serves a critical role, extending health care coverage to an array of citizens—including lower-income residents, older adults, and individuals grappling with disabilities among others; this program is tasked with administering these services to nearly 2.9 million, stressing the gravity of fiscal management and the need for steadfast compliance, which in this case, where Empowered for Excellence is concerned, appeared to falter. The agency, having received $14.9 million for a range of substance use disorder, mental health, and professional medical services from the start of 2021 through the end of 2023, was scrutinized over questionable practices like authorizing treatments not included in plans, lacking substantial documentation, and delivering services that exceeded daily limitations.
According to the Auditor's office, the findings come at a moment when vigilance in spending, especially related to Medicaid, assumes heightened importance as states like Ohio work within narrowing fiscal constraints to deliver essential services to their most vulnerable citizens. As dictated by statute and through an accord with the Department of Medicaid, the Auditor of State's role includes auditing Medicaid providers to assure proper use of funds following state and federal guidelines.
The Department of Medicaid and the Ohio Attorney General's Office, the entities often at the helm of enforcement, now face the task of ensuring compliance and the recovery of funds deemed excessively or inappropriately disbursed, such are the procedures when audit findings, like those besetting Empowered for Excellence, are brought to light—the full extent of these findings being accessible in the comprehensive report made available online. For its part, Empowered for Excellence, a certified agency, has included its response to the audit's findings within the reported document, positioning the entity within the broader conversation of healthcare funding and the assurance that taxpayer dollars align with their intended purpose.
