Millions in Medicaid benefits were paid out for Ohioans who were ineligible for them, or even dead, according to a new interim report from the Ohio Auditor of State's Office.
The auditor's office reviewed programs for the Medicaid recipient population known as Aged, Blind and Disabled (ABD), made up of roughly 500,000 Ohioans, over a 30-day period. Of the 1,500 individuals sampled, 49 were not eligible to receive those benefits, including 25 who did not meet eligibility requirements based on their bank accounts, personal and real property, investments, and other nonexempt resources, according to the report. That included several individuals who had more than $1 million "at their disposal."
Of the nearly 500,000 overall, the auditor's office also
found that 3,000 dead individuals had Medicaid benefits paid on their behalf.
In total, the auditor's office found over $2 million in fixed monthly payments made to medical providers for those who shouldn't have had or didn't need Medicaid benefits.
“The Ohio Department of Medicaid continually fails to properly administer these programs,” Auditor of State Keith Faber said in a press release. “Every dollar they spend on people who aren’t eligible for public resources is a dollar that’s not helping the truly needy among us.”
Auditor says issues leading to fraud have been around for a while
The audit comes at a time where federal and state officials alike are more heavily scrutinizing where Medicaid money goes. Earlier this year, the Ohio Attorney General's Office charged six Medicaid providers with fraud as part of a crackdown on alleged widespread misconduct, spurred on by claims from a conservative website that caught the attention of Republican lawmakers at every level of government.
Faber, a Republican, is running against Democrat attorney John Kulewicz in the November election for Ohio's attorney general.
As part of the state's most recent budget, Ohio's legislature directed the auditor's office to review Medicaid enrollment for ABD. This population must meet specific, multilayered eligibility criteria to continue to receive these health care benefits.
In the report, the auditor's office attributed some of these issues to the Ohio Department of Medicaid's (ODM) eligibility process, which include infrequent eligibility reviews and outdated applications. These problems have, at least in part, been known since 2019, according to the auditor's office, "but have either gone unaddressed or have received an inadequate response from ODM."
"Ohio Medicaid appreciates the Auditor of State’s work and is reviewing the interim report closely. We are committed to strong oversight, transparent operations, and making improvements where needed," a spokesperson for ODM said in an emailed statement.
The department also points to Ohio's reported 2% payment error rate overall. That's lower than the report's 3% as well as the national average. Still ODM said, "Ohio Medicaid has already begun implementing improvements aligned with the findings."
ODM administers approximately $40 billion in health care and related programming for roughly 3 million Ohioans, more than one-third of which are children.
In its report, the auditor's office recommended that ODM simplify and create clearer rules around what does and doesn't count as an asset that's considered when assessing Medicaid eligibility. This, the auditor's office said, reduces the risk of those with over $1 million "at their disposal" receiving Medicaid benefits. Other suggestions included more staff training as well as using a better and more updated application for processing payments.
Business and consumer issues reporter Samantha Hendrickson can be reached at shendrickson@dispatch.com
This article originally appeared on The Columbus Dispatch: Auditor finds Ohio doled out Medicaid money for dead, ineligible Ohioans
