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Guidelines monitoring Ohio’s Medicaid need continuous enforcement

By Our Side 2 min read

A recent review of Ohio's Medicaid enrollment by state Auditor Keith Faber's office found plenty of people enrolled who should not be receiving benefits - and it is not perhaps the group of people some low-aiming politicians hope you would expect.

According to a report by The Center Square, the audit found 3% of Buckeye State residents receiving Medicaid benefits have more resources than allowed. In fact, "several" of those people are millionaires. Further, Faber's office reported more than 3,000 people receiving state Medicaid benefits are dead.

Ohio spends approximately $40 billion a year on the program. That's $40 billion of our money.

"The taxpayers of this state should not be footing the bill for millionaires and others who have adequate means to pay their own way," Faber said. "Time and time again, we've identified weaknesses in the Ohio Department of Medicaid systems that can lead to fraud, waste and abuse of public resources. The issues we have identified have not been corrected."

The good news is perhaps that last concern is about to change, as lawmakers who requested the review have also passed reforms that would add tighter guardrails and improve data collection and monitoring.

Among reforms are changes to the "pay and chase" model, and a plan to "stop faulty payments before they are made, and require prior authorization for personal care services and some therapies before providing them," according to Buckeye Institute vice president of policy Rea Hederman.

It sounds as though now, then, the question is whether those reforms can be enforced in a way that deters the kind of person who has millions of dollars sitting in the bank and still tries to claim Medicaid benefits. (And the kind of person who lets that sort of thing slide.)

Lawmakers have taken some important steps. Given Faber's findings, the important thing now is not to back off.

Starting at /week.