Ohio Gov. Mike DeWine’s administration is suspending Medicaid payments to 49 home health care providers that exhibited red flags for potential waste, fraud or abuse.
Since January, the Ohio Department of Medicaid has used data analytics to identify providers with questionable billing practices. On June 4, the agency announced it was temporarily suspending payments to 49 providers with billing patterns and data anomalies that suggested “a high probability of fraudulent activity.”
“These initial suspensions mark a critical step forward in ensuring accountability and deterring abuse within the Medicaid system,” Ohio Department of Medicaid Director Scott Partika said in a statement. “We will continue using advanced analytics and enforceable action to protect Ohioans and preserve program integrity.”
The suspended providers, mostly from central Ohio, represent a small share of the more than 53,000 offering home health services statewide.
The suspensions come after a conservative publication published a series of articles detailing allegations of Medicaid fraud within the home health care program, particularly in Columbus’ Franklin County. Home health care allows patients to receive nursing and other services in their homes rather than in a nursing facility.
Top Republican lawmakers blamed DeWine’s former Medicaid director for failing to do enough to combat fraud.
Ohio lawmakers are now considering legislation to prevent Medicaid from paying relatives to assist with personal care, such as bathing, dressing, meal preparation and medication reminders. If approved, the change would create a provider shortage at a time when Ohio Medicaid has paused adding new home health care and hospice businesses.
“Abrupt reductions in provider capacity will put older adults and individuals with disabilities at risk of institutionalization,” wrote Kerstin Sjoberg, CEO and president of Disability Rights Ohio, which advocates for Ohioans with disabilities. “It is imperative that people with disabilities do not lose access to care, services, and their right to live in the community.”
Republican Vivek Ramaswamy and Democratic Dr. Amy Acton, who are running to replace DeWine, have both called for an investigation into fraud allegations. Ramaswamy proposed working with President Donald Trump’s administration to allow Ohio to keep at least two-thirds of the dollars in Medicaid savings.
State government reporter Jessie Balmert can be reached at jbalmert@gannett.com or @jbalmert on X.
This article originally appeared on The Columbus Dispatch: DeWine administration cutting off Medicaid payments to 49 providers
Reporting by Jessie Balmert, Columbus Dispatch / The Columbus Dispatch
USA TODAY Network via Reuters Connect
By Jessie Balmert, Columbus Dispatch | USA TODAY Network
