Pointing to millions of dollars in unpaid debts owed by Medicaid providers, state Auditor Dave Yost says Ohio should require surety bonds so the state can more easily recover fraudulent or over payments.
Former state auditor Betty Montgomery recommended a limited use of surety bonds — 12 years ago — in a 2006 top to bottom review of Ohio Medicaid.
Medicaid is a state and federally funded health care program that pays for half of the births in Ohio and the majority of nursing home care, reimburses 110,000 providers, covers 3-million Ohioans and consumes 39 percent of the state budget. The program has received $134 billion in state and federal money since 2011.
Auditors look for red flags and then do examinations to determine whether the money is properly spent. Over the past seven years, auditors flagged $33.3 million in over payments to 121 providers and a follow-up analysis of 60 of those providers have paid back just $1.9 million of $19.7 million owed.
Yost’s team found instances of Medicaid transportation companies employing drivers without valid licenses, home health care aides without basic first aid training and other problems.
“For too long, dishonest providers have exploited vulnerabilities in the Medicaid program with little consequence,” Yost said.
Yost is backing a bill sponsored by state Sen. Peggy Lehner, R-Kettering, to require surety bonds — insurance mandated for Medicaid providers in Indiana, Texas, New York and Florida. Yost said he’d like to see lawmakers adopt Senate Bill 218 by the end of the year.
Among the Medicaid provider examinations done in the Miami Valley since 2011, Yost found $4.57-million in fraudulent or improper payments made to 10 providers, including six independent nurses and two medical transportation companies. Healing Touch Healthcare LLC in Montgomery County was found to owe $3.7 million, according to Yost.
Debt collection is the responsibility of the Ohio Attorney General — an office Yost is running for against Democrat Steve Dettelbach.