Summit Academy accused of incorrect billing

Staff report

COLUMBUS

Summit Academy-Youngstown billed for services for students who were absent or not enrolled on the dates of service, according to a Medicaid audit released by the state auditor’s office.

“How do you provide services to students who aren’t even enrolled at the school?” Auditor Dave Yost said. “You don’t. This is an old-school rip-off.”

The audit determined that the charter school was overpaid by Ohio Medicaid for services rendered between July 1, 2011, and June 30, 2013, for nearly $14,664. With $1,012 interest, Summit Academy owes the Ohio Department of Medicaid $15,675.

The school referred questions to Summit Academy Management in Montrose. A receptionist at the management company said the company had no comment.

Auditors reviewed attendance records and determined that recipients listed for 14 billed services were absent or not enrolled on the dates of service. In 13 of those instances, the provider had service documentation that included a start time, end time and a detailed note. The audit also identified nine services with no supporting documentation and three services in which the provider billed the wrong procedure code, resulting in an overpayment.

The audit also examined Individualized Education Programs, which are required for recipients of special-education services, and found these errors:

Twenty-two services in which the provider billed for more units than were authorized in the IEPs.

Two services that were not authorized in an IEP.

Three services with no IEPs to cover the dates of service.

The provider did not submit proof that a speech-language pathologist, who had a conditional license, practiced under the supervision of a fully-licensed speech-language pathologist. Auditors concluded that 43 services rendered by the pathologist with a conditional license were noncompliant.

Auditors also determined that one of the provider’s practitioners failed to complete a background check, and three practitioners rendered services before completing their background checks. As a result, auditors concluded that 38 services rendered by the practitioners were noncompliant.