Medical co. fined for Medicaid overcharge

Published 6:41 pm Thursday, July 8, 2010

A Brookhaven and McComb medical business is paying more than$300,000 to the state after an audit found billing errors to thestate Medicaid office.

According to information from the Mississippi Attorney General’sOffice, McComb-headquartered Thrift Home Care, a medical equipmentdealer, has agreed to repay more than $217,000 to the Division ofMedicaid for claims that were not properly reimbursable. Thecompany will also fork over $100,000 to cover penalties and legalcosts.

The AGO claims Thrift used the wrong Medicaid billing codes fordisposable diapers and billed the division for adult diapers. Theoffice claims the errant billing was done from 2002-2009.

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But Minor Griffin, Thrift’s marketing director, said his companyacted in accordance with Medicaid’s instructions, even afterdiscovering the error and reporting it. He said Thrift receivedprior approvals for all diaper billing and, after bringing thecoding mistake to Medicaid’s attention, was told to continuebilling in the same manner.

“Then they came back on an audit and decided it was the wrongcode,” Griffin said. “We never really thought we were treatedfairly in the whole thing. We pretty much realized there at the endwe would spend that much in attorney fees trying to fight it, so wejust went ahead, bit the bullet and settled.”

Thrift Home Care Manager Sylvia King said the AGO’s press releaselisted the wrong dates, and the company is working with itsattorney to file a rebuttal.

“It looks like we’ve been inaccurately billing diapers from 2002 to2009, when in actuality we identified the error during an audit in2004,” she said. “We’ve been disputing the amount for the past fiveyears with our attorney.”

King said Thrift received inaccurate coding information fromMedicaid in the beginning, and the company has approval for everybilling. She said the diapers the company billed for werereimbursable at 20 cents, while the codes used in the billingbrought reimbursements of 90 cents.

“It’s not like we just picked out a code and said, ‘We’re going tobill this,'” she said.