Medicaid Improperly Billed in Columbia, Audit Says

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A Columbia nursing facility improperly billed Medicaid nearly $5,000, according to an audit Tennessee Comptrollers released Monday.

In their audit, Comptrollers called out the Life Care Center of Columbia.

This audit comes as several mainstream media outlets in Tennessee seem to urge state leaders to expand Medicaid.

The most recent one was The Daily Memphian, in a glowing piece about newly-elected State Rep. Jesse Chism, D-Memphis.

But, as Monday’s audit and many others reveal, people tasked with handling Medicaid expenses often make mistakes and bill the taxpayers more than necessary.

According to the audit, Life Care Center of Columbia improperly billed the Medicaid Program for 31 noncovered days from 2014 through 2016.

“Of the improperly billed days, 27 were for hospital or therapeutic leave days when the facility was operating below 85 percent occupancy, one was for a hospital leave day that exceeded the 10-day leave rule, and three were billed after a resident was discharged from the facility,” auditors wrote.

The facility, Comptrollers went on to say, should refund $4,811 to the Medicaid Program.

In another finding, Comptrollers said staff members inappropriately charged Medicaid residents’ trust fund accounts for shampoos and haircuts, which are Medicaid- covered services.

“As a result of the inappropriate charges from January 1, 2014, through November 30, 2016, the facility should reimburse 105 Medicaid residents or their authorized representatives a total of $3,478.10,” Comptrollers wrote.

In an emailed statement, Life Care Center spokeswoman Leigh Atherton said staff members voluntarily refunded the money after the audit findings came out.

“After the discovery, all Life Care facilities statewide were trained as an additional precaution,” Atherton said.

This week The Daily Memphian seemed to complain that Medicaid is unlikely to expand under a Republican supermajority in the Tennessee General Assembly.

“The Tennessee Black Caucus of State Legislators is planning to make another push for expanding Medicaid when the session opens in 2019,” the paper reported in their profile of Chism.

In his interview with the website, Chism seemed to favor Medicaid expansion.

As The Tennessee Star reported Monday, mainstream media outlets across Tennessee continue to beat the drum for expanding Medicaid, hoping to sway most Volunteer State residents to see things their way.

But, as The Tennessee Star reported, expanding Medicaid brings peril.

Beacon Executive Vice President Stephanie Whitt, writing for KnoxNews.com, said there are several important matters to consider, not the least of which is the notion Tennessee gets free money.

“This is not free money,” Whitt wrote.

“Expansion would be paid for with new federal taxpayer dollars, borrowed from our children and grandchildren, that are not guaranteed in the future. This could potentially put our state at risk to either shell out additional state taxpayer dollars to cover the expanded population or go through the painful process of kicking hundreds of thousands of people off the program.”

Medicaid is expensive, Whitt said.

TennCare costs Tennesseans $12 billion, eating up nearly a third of the state’s $37.5 billion total budget, she said.

“To put that in perspective, Tennessee is spending approximately $32.8 million per day on TennCare,” Whitt said.

“It is simply unrealistic to think we can expand our TennCare population by a minimum of 250,000 people (some estimates put that number even higher) and be able to sustain the program over time.”

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Chris Butler is an investigative journalist at The Tennessee Star. Follow Chris on Facebook. Email tips to chrisbutlerjournalist@gmail.com.

Photo “Life Care Center of Columbia” by Life Care Center of Columbia.

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