Medicaid IG wants Ulster's CP agency to return $2.27M

Published: 2:00 AM - 09/27/13

KINGSTON United Cerebral Palsy of Ulster County Inc. should pay the state $2.27 million for overbilling the state Medicaid program, according to the Office of Medicaid Inspector General.

The inspector general's office issued a news release Wednesday detailing its findings. They are based on the agency's audits of the UCP program's bills submitted for 2005 through 2008 and Jan. 1, 2009 through March 31, 2010. Auditors pulled a sample of the billing and examined them in detail. They found "excessive levels of missing documentation," the news release said. The most common error was treatment plans that lacked the signature of a physician.

Medicaid Inspector General James C. Cox said: "Without proof that a doctor has ordered a service, no one can verify that a service should have or was provided."

No money was reported stolen, a representative for the inspector general said later.

The auditors used their sample to project mistakes and deficiencies for the rest of the bills from UCP. That projection tagged the overpayments at nearly $1 million in one audit and $1.27 million in the other.

Linda Clark, a lawyer for UCP of Ulster County, said her client is appealing the audit findings and called the inspector general's office "overzealous," "inconsistent" and "inefficient."

"The reality is that in each and every instance cited by OMIG in its audit report, we provided ample documentary evidence and records of physician directed services that were actually and competently provided to a qualified patient who received and benefited from the services of UCP," she said in an email statement.

Clark said the inspector general's office engaged in "misinterpretation of shifting and outdated record-keeping requirements that are often vague and confusing." On top of that, she said, the inspector general wants "to retroactively take back from the agency 100 percent of payments made for services including those which were undisputably provided. ..."

pbrooks@th-record.com

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Medicaid IG wants Ulster's CP agency to return $2.27M