My wife Penny is an #Ohio independent #Medicaid provider and every September she gets an audit and colonoscopy, called a Structural Review, from Ohio Dept of Medicaid's corporate contractor, Republican donor William 'Bill' Mosakowski's Public Consulting Group, that the Ohio #GOP awarded the contract to. Non-Medicare agencies get reviewed every two years.
This company is so dysfunctional.
If there is a problem with Medicaid fraud in Ohio, the first place Ohio needs to look is the corporate donor buddies they award the oversite contracts to.
They also own Staffing Solutions Organization LLC and University Instructors LLC.
The Structural Reviews are meetings between PCG and the provider, which include review of the provider’s documentation and supporting evidence to ensure:
Compliance with the Ohio Administrative Code (OAC) rules for provider performance for the delivery of the services, adherence to providing and billing for services as authorized, and review of the clinical documentation to support reimbursement of services. #USPol
https://ohiohcbs.pcgus.com/structural-reviews