Ohio auditor: Medicaid providers ducking refunds owed to state

The Columbus Dispatch | Catherine Candisky

Medicaid service providers cited for improper payments in past state audits have repaid just a fraction of the tens of millions they owe the state, according to a new report by state Auditor Dave Yost.

“For too long, dishonest providers have exploited vulnerabilities in the Medicaid program with little consequence,” he said. “A stronger system of controls is necessary to protect the program’s vital resources and the citizens who need them most.”

In the past seven years, the auditor’s office has performed compliance examinations of 133 Medicaid providers, flagging $33.3 million in improper payments. The payments to medical-transportation companies, home-health-care aides and other providers typically result from charging for care they are not certified to provide, or for services that lack required documentation.

A recent follow-up analysis of 60 of those providers disclosed that they have repaid only 9.6 percent of the $19.7 million they were ordered to reimburse the Ohio Department of Medicaid.

“All of these transgressions put patients at risk for inadequate care, waste valuable public resources and undermine the public’s faith in the Medicaid program,” the 20-page report said.

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