Comptroller Audit Finds Franklin Health Clinic was Overpaid $6 Million
An audit by the Tennessee Comptroller’s Office found a health clinic based in Franklin, Tennessee has been submitting inaccurate information to the State of Tennessee and has been overpaid $6,094,078.01.
An audit revealed that ProHealth Rural Health Services, Inc. over-reported the number of TennCare patients that visited its Middle Tennessee clinics by 56,251 visits. As a result, the Division of TennCare overpaid millions of dollars to the clinic that it was not entitled to.
ProHealth is a type of Federally Qualified Health Center that is eligible for reimbursement from TennCare for services provided to Medicaid patients. Comptroller auditors determined that ProHealth submitted inaccurate information to the state from January 1, 2012 through June 30, 2017.
In some cases, ProHealth double and triple counted visits. For example, during an office visit a patient may have had multiple services performed, such as a preventative exam, hearing test, eye screening, and a developmental screening. These multiple services should only count as one visit; however, in many instances, ProHealth counted each service as a visit.
The Tennessee Office of the Attorney General is currently seeking civil penalties and treble damages against ProHealth under the Tennessee Medicaid False Claims Act in the United States District Court for the Middle District of Tennessee.
To view the report, go to: https://comptroller.tn.gov/content/dam/cot/sa/advanced-search/2019/md18019.pdf
If you suspect fraud, waste or abuse of public money in Tennessee, call the Comptroller’s toll-free hotline at 800.232.5454, or file a report online at: www.comptroller.tn.gov/hotline. Follow us on twitter: @TNCOT
Media contact: John Dunn, Public Information Officer, 615.401.7755 or john.dunn@cot.tn.gov
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