Another agency pays a big price for inadequate records. This is what happens when people are not using Therap Services.

Upstate Agency overbilled Medicaid by $2.27 million
KINGSTON – Excessive levels of missing documentation will cost an agency big bucks. That agency is going to have to repay New York’s Medicaid program $2.27 million after two audits by the Office of Medicaid Inspector General discovered overpayments.The audits reviewed the day treatment program services. Out of 200 records reviewed in the audit, 107 contained deficiencies. The largest category of error involved missing documentation that would have provided evidence that a physician had reviewed an individual’s treatment plan.

“Physicians must authorize services, and their medical knowledge is the cornerstone of establishing medical necessity,” said Medicaid Inspector General James Cox. “Without proof that a doctor has ordered a service, no one can verify that a service should have, or was, provided.”

Other findings included missing records that would prove that a service has been provided or missing progress notes, despite the fact that the services had been billed and paid by Medicaid.