Louisiana Department of Health

Auditor Confirms Medicaid Provider Violated State Law

For Release On:

February 26, 2018

BATON ROUGE: In an audit released today, the Legislative Auditor confirmed the Louisiana Department of Health’s on-going investigations of JABA Enterprises, LLC (JABA) for improperly billing the State for Medicaid services.

JABA has been the subject of numerous reviews and investigations by the Louisiana Department of Health for possible fraudulent billing practices. This includes the company submitting claims for more than $1.3 million that were denied payment by the department. On at least 10 occasions, LDH has turned over its findings to investigators with the state’s Medicaid Fraud Control Unit for additional review or investigation. The evidence provided by LDH to the Attorney General’s office resulted in the arrests of seven JABA employees last summer.

In addition to the arrests, the department has also excluded JABA from the Louisiana Medicaid program and terminated its provider agreement, effectively barring the company from receiving Medicaid payments. Other violations uncovered by LDH include:

  • Failure to conduct mandatory supervisory visits
  • Inadequate documentation to support billing
  • Incomplete, non-existent or unsigned service logs
  • Failure to complete mandatory sanction checks
  • Missing documentation of annual training requirements
  • No evidence of annual evaluations of employees
  • Performance of unapproved services

In its audit of JABA, the Legislative Auditor said the company may be in violation of its Medicaid provider agreement.

Jen Steele, Medicaid director, said the department has controls in place, as well as investigators who routinely monitor providers for services that are not properly documented. “When investigations confirm cases where services are not properly documented, the department takes action to recover any overpayments,” she stated.

“In instances where a provider is suspected of committing fraud, the department makes a referral to the state’s Medicaid Fraud Control Unit with the Attorney General’s office for further review and possible prosecution,” Steele added.

Last year, a report issued by the U.S. Department of Health and Human Services, Office of Inspector General recognized Louisiana for full compliance with the federal Medicaid fraud prevention and reporting requirements, has the proper procedures in place to report fraud, and made no recommendations for further improvements. Louisiana was one of only four states to pass this audit since 2014.

Original Press Release http://www.dhh.louisiana. gov/index.cfm/newsroom/de tail/4553

Republished by LOUISIANA NEWS | www.louisiana.gov