Toledo behavioral health provider owes state $1.87M for improper Medicaid claims

TOLEDO, Ohio — A Toledo-based behavioral health agency must repay nearly $1.87 million to the state after a Medicaid audit found widespread billing and documentation violations - findings the agency’s CEO disputed, calling them clerical errors rather than evidence of overbilling.

The audit of Empowered for Excellence Behavioral Health of Ohio reviewed payments made between Jan. 1, 2021, and Dec. 31, 2023, and identified $1.75 million in improper claims, plus $115,000 in interest. The Ohio Auditor of State issued an adverse opinion, citing repeated noncompliance with Medicaid rules.

Among the issues cited:

Claims submitted without supporting service documentation

Missing or incomplete treatment plans authorizing services

Duplicate or excessive billing on the same date of service

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