Most Medicaid overpayments never recovered

The Toledo Blade | Jim Provance

Transportation, home health-care, and other service providers found to have been paid for Medicaid services they couldn’t prove they provided have repaid just a fraction of what they owe, state Auditor Dave Yost said Tuesday.

OBJECTHe’s thrown his support behind Senate Bill 218, which would require many such providers to acquire surety bonds, an insurance policy backing up their work, as a condition for participating in the federal-state health-care program of last resort for the poor, infirm, and disabled.

That would give the state another option to recover money paid to providers who can’t supply proper documentation for their billings, have workers who lack required training or certification, or billed for services provided without prior authorization.

Over the past seven years, the auditor’s office flagged $33.3 million in improper payments, plus $2.4 million in interest, to 121 Medicaid providers. A recent review of 60 of those previously flagged providers showed that they’d repaid just $1.9 million of $19.7 million owed as of November, 2017.

“That’s about 9.6 percent paid,” Mr. Yost said. “Over 90 percent of the money we’re not getting back.”

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