(The Center Square)– Ohio’s governor has imposed new measures to cut down on Medicaid fraud, even though he says the state is already far ahead of most states in cracking down on abuse.
“Ohio has long been a national leader in fighting Medicaid fraud,” Gov. Mike Dewine said in a statement. “Ohio has one of the best Medicaid Fraud Control units in the country,”
In 2018, the state was the first to require electronic verification for home health care visits paid by Medicaid, a joint state-federal health insurance program for low-income and disabled people, DeWine said.
The state now wants the federal government to approve a six-month moratorium on new home healthcare and hospice businesses for Medicaid patients.
“This will allow Ohio Medicaid to stop enrollment of new providers and assess existing providers to help remove those at high risk for having committed fraud,” the governor said in a news release.
Also, the state has launched a new policy to immediately halt payments to providers whose billing practices show warning signs of fraud.
In January, the state started using new data analysis tools to flag abnormalities in billing that could indicate fraud. The state has identified 87 providers for additional review and possible suspension of payments, DeWine said.
The state is also exploring the use of artificial intelligence tools to “stay one step ahead of anyone looking to exploit the system,” the governor said.
Medicaid fraud has been in the national spotlight for months following reports of widespread abuse in states such as Minnesota, California and other states.
This week, the Trump administration will defer $1.3 billion in Medicaid funds to California over fraud concerns.
“There are California taxpayers and American taxpayers who are being defrauded because California isn’t taking its program seriously,” Vice President J.D. Vance said in announcing the deferral.
He went on to say that many states are not working hard enough to fight Medicaid fraud.
“They don’t think the fraud is a big enough problem,” Vance said. “They don’t care about protecting that Medicaid program.”
