Review finds millionaires on Ohio's Medicaid roles

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(The Center Square) – Three percent of Ohioans on Medicaid were not eligible because they have more resources than allowed, including several millionaires, according to Ohio Auditor Keith Faber.

More than 3,000 dead people were also continuing to have benefits paid, Faber said Tuesday after a recent review of the state’s Medicaid program. The findings are part of an interim report that covers Medicaid programs for the Aged, Blind and Disabled population. 

The current state budget required the state auditor to review enrollment in those programs to determine whether Ohioans receiving assistance were actually eligible for the support.

Medicaid is the joint state-federal health insurance for low- income residents. Ohio spends about $40 billion annually on the program.

 “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.”

Faber identified some of the reasons for the incorrect payments, including eligibility reviews that are not performed more frequently and outdated versions of applications.

The solutions include much tighter guardrails for the Medicaid program and improving better data collection and sharing in Ohio, Greg Lawson, senior research fellow at the non-profit Buckeye Institute, told The Center Square..

“Recent Medicaid reforms passed back in the summer should help,” Lawson said.

One problem has been Ohio’s “pay and chase” model, Buckeye Institute vice president of policy Rea Hederman, recently wrote.

“Ohio increasingly relies on home-care services to help seniors and patients with disabilities receive humane, flexible, personalized and more affordable care,” Hederman wrote. "Organized fraud rings exploit weak verification systems and pressure patients to sign timesheets for care they never received.”

Ohio is tightening oversight to reduce fraud, said Hederman.

“Recent reforms look to revamp the ‘pay and chase’ model, stop faulty payments before they are made and require prior authorization for personal care services and some therapies before providing them,” he wrote.