The Nebraska Department of Health & Human Services (State agency) did not always claim Medicaid reimbursement for non-emergency medical transportation (NEMT) services in accordance with Federal and State requirements. Of the 100 paid claims in our random sample, 33 claims had 70 errors of improper Medicaid reimbursement (some claims had more than 1 type of error). The errors included claims with 59 NEMT services that were not rendered, including instances for recipients who had either canceled the requested service or were "no-shows" at the scheduled origination address, and claims with 11 unsupported services.
Based on our random sample, we estimated that the State agency improperly claimed $90,000 ($55,000 Federal share) in Medicaid reimbursement for NEMT services from July 1, 2007, through June 30, 2009.
Dallas L Alford IV, CPA is a licensed Certified Public Accountant in the state of North Carolina and owner of Atlantic Financial Consulting, a consulting firm that provides comprehensive medical billing services, practice management consulting, coding audits, Medicare compliance, Medicare RAC support and other general medical practice consulting services.
To learn more about Atlantic Financial Consulting you may visit their website at
http://atlanticfinancial.us or contact Dallas L Alford IV, CPA directly at 1 888-428-2555, Ext. 200.
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