Evidence record
Independent Auditor’s Report On Compliance With Requirements Of The Medicaid Program
- Jurisdiction
- Ohio
- Publishing agency
- Ohio Auditor of State
- Publication date
- May 13, 2026
- Source record
- Metadata record
Findings
8
Recommendations
4
Overall conclusion
In our opinion, except for the effects of the matters described in the Basis for Qualified Opinion paragraph, New Destiny has complied, in all material respects, with the select requirements of behavioral health services for the period of January 1, 2021 through December 31, 2023.
Scope
Behavioral health services provided to Medicaid recipients by New Destiny Treatment Center, Inc. for January 1, 2021 through December 31, 2023, focusing on provider qualifications, service documentation, service authorization, and billing practices for selected services including those in the procedures table.
Findings (8)
Each finding has a stable link.
- F-1358
Noncompliance related to services billed during potential inpatient hospital stays: 7 non-compliant services, 9 non-compliance errors, $1,232.86 improper payments.
- F-1359
More than one per diem service billed on a RDOS: 633 non-compliant services, 633 non-compliance errors, $113,038.22 improper payments.
- F-1360
UDS services exceeding limitations on an RDOS: 37 non-compliant services, 37 non-compliance errors, $535.76 improper payments.
- F-1361
UDS service billed on the same RDOS as a residential service: 12 non-compliant services, 12 non-compliance errors, $173.76 improper payments.
- F-1362
SUD group counseling on the same RDOS as a residential service: 4 non-compliant services, 4 non-compliance errors, $133.92 improper payments.
- F-1363
Residential services requiring prior authorization after 30 consecutive days of admission through day 50: 45 non-compliant instances, $8,699.55 improper payments.
- F-1364
Alcohol and/or other drug treatment program services sample: 2 non-compliant instances, $427.40 improper payments.
- F-1365
Intensive Outpatient Program (IOP) services: 66 non-compliant services, 82 non-compliance errors, $1,097,435.00 improper payments.
Recommendations (4)
- R-1226
Develop and implement procedures to ensure all service documentation and billing fully comply with Ohio Medicaid rules; establish a quality review process to verify documentation before claims submission.
- R-1227
Ensure treatment plans substantiate billed services, are updated as recipient needs change, and are signed by the recording practitioner; verify sufficient prior authorization where required.
Related finding F-1363 - R-1228
Implement controls to ensure per diem services do not exceed limits, and that residential treatment services are not billed separately from residential care.
Related finding F-1359 - R-1229
Address the identified issues to improve Medicaid rule compliance and prevent future findings.