MEDICAID Doctor was improper in billing, audit says

The doctor complained about the obsession with documentation.
By DAVID SKOLNICK
VINDICATOR POLITICS WRITER
YOUNGSTOWN -- A state auditor's office investigation determined that a Youngstown doctor improperly billed $19,337.40 in Medicaid reimbursements over a three-year period.
The audit of Dr. Richard M. Kalapos, who has a medical practice on North Garland Avenue, was initiated by the state auditor at the request of the Ohio Department of Job and Family Services.
The auditor will turn over the report today to ODJFS, the state agency that administers the Medicaid program in Ohio. If Dr. Kalapos doesn't pay $19,337.40 by early July, the matter can be turned over to the state attorney general for collection.
The audit, released today, says that Dr. Kalapos billed Medicaid $18,997.55 for unallowable reimbursements for developmental testing of children between April 1, 2000, and March 3, 2003.
The audit states the doctor tested 622 patients to determine communication, social, emotional and cognitive development skill tests not permitted under state law for Medicaid reimbursement. But the doctor submitted requests and received reimbursement from the state through Medicaid for the services.
The report states there was no evidence of formalized testing and no written reports in patient records of the tests.
Dr. Kalapos couldn't be reached Monday to comment.
Losing sight
But in an April 28 letter to the auditor's office, he wrote: "It is sad that our profession has become so obsessed with documentation that we lose sight of outcome as I have a large number of children from my practice that have been identified, referred and received treatment for their developmental delays."
The rest of the findings for recovery are for noncovered Medicaid services, duplicate payment, and unsupported services, the audit reads.
Medicaid is a program that provides health coverage to low income people.
skolnick@vindy.com