Dispute Concerning An Audit of Medicaid-Covered Nursing Home Services
Examination of Waiver Indicated a Request of Final Settlement and Determined That Money Was Due to ODHS Not to the Appellant:
In In re Bolton Convalescent Home v. Ohio Dept. of Human Services (Feb. 28, 1995), a dispute arose concerning an audit of Medicaid-covered nursing home services.
Relying on a waiver that the Department of Human Services asserted contained a typographical error, the appellant claimed that this waiver was the only reliable, probative, and substantial evidence in the record and that execution of this waiver created a binding contract that clearly and unambiguously indicated that money was owed to appellant, rather than to the Department of Human Services.
In In re Bolton, this court stated:
We do not believe the trial court was constrained to accept appellant's assertion that the only reliable, probative, and substantial evidence was the waiver. An examination of the waiver itself indicates that it contains a request for implementation of the final settlement for the reimbursement period in question. Therefore, it was not an abuse of discretion for the trial court to find that the waiver requested implementation of the final settlement, and to look to the report of final settlement in determining that the $ 12,906.51 was due to ODHS and not appellant. Id.