Ohio says it is immediately implementing anti-fraud measures in the home health sector, days after claiming it already had such measures, and after a Daily Wire report showed how the administration of Gov. Mike DeWine actually turned off previously-existing fraud protections.
The about-face comes after Vice President JD Vance, who also hails from Ohio, announced on Wednesday that the federal government would be suspending the enrollment of any new home-health companies in the Medicaid program for six months.
DeWine announced in response that he was implementing “several new fraud prevention initiatives” that had been “long in development” to fight fraud, waste, and abuse in Medicaid.
The announcement comes amid a Daily Wire investigative series into home health care waste, fraud, and abuse. It comes just a week after the DeWine administration attempted to dismiss The Daily Wire’s series, telling other media outlets that “Ohio has extensive oversight mechanisms in place,” including a safeguard called “Electronic Visit Verification,” or EVV.
Ohio spends $1 billion a year on “home health,” most often to people who aren’t medical professionals, to provide services like “chores,” “companionship,” and “conversation.” The people getting paid by Medicaid are frequently the patients’ own family members.
The DeWine administration initially attempted to dismiss The Daily Wire’s series, telling other media outlets that “Ohio has extensive oversight mechanisms in place,” including a safeguard called “Electronic Visit Verification,” or EVV.
It garnered sympathetic coverage in local outlets like the Columbus Dispatch, who played down the scandal after the Ohio Department of Medicaid told media May 5 that, “To confirm that billed services are actually rendered, ODM relies on an extensive set of safeguards, including… Mandatory electronic visit verification capturing date, time, and service location.”
But it turns out that wasn’t entirely true. On Monday, The Daily Wire revealed Ohio wasn’t actually requiring meaningful EVV. For years, Ohio had been paying people even if there was no verification, according to public testimony by Auditor Keith Faber. Furthermore, the state neutered EVV by making GPS optional, citing privacy concerns for patients.
Dave Yost, the former attorney general of Ohio, had complained to the legislature that making GPS optional had made detecting fraud impossible.
“Until about a year ago [GPS] was required, now it’s optional,” Yost told legislators in March. “I do not know for the life of me why it went away, but I respectfully ask you to put in statute where no vendor, no bureaucrat can object to legitimate monitoring.”
Ohio Department of Medicaid spokeswoman Stephanie O’Grady told The Daily Wire five days ago that the change was necessary because of patient “privacy.”
“Effective July 1, 2024, GPS functionality within any EVV application or device may only be activated with the signed consent of the individual receiving services—valid for one year and revocable at any time. The approach allows the person receiving care to make an informed decision related to privacy protections for individuals receiving home and community-based services,” she said in an email.
DeWine’s administration says it has been taking steps to reimplement the requirement since late last year.
“In December, DeWine authorized Ohio Medicaid to begin the information technology investments needed to make GPS mandatory for EVV. Ohio Medicaid [is] now ready to make this rule change to implement the requirement,” it said.
But Ohio’s implementation of EVV is still easily gamed: Even though it paid $146 million to work with a large provider of tracking software, it allows home health aides to use other software instead, and those systems simply transmit the coordinates as plain text, potentially making it possible to submit fake coordinates.
As The Daily Wire’s series continues to document the people who own home health companies – such as a husband-and-wife team with repeated convictions for fraud, theft, and assault – the DeWine administration began to backtrack from its initial posture. O’Grady said Monday that “improvements were already underway, and The Daily Wire series provides a great reminder as to why we have been pursuing these stronger safeguards for future implementation.”
DeWine said on social media Wednesday, “Today I announced several new fraud prevention initiatives to strengthen and build upon long-standing efforts to fight fraud, waste, and abuse in the Ohio Medicaid System. We are ready to begin these initiatives long in development that will enhance Ohio’s nation-leading work.”
State lawmaker Mike Dovilla, a Republican who has been critical of the governor, replied: “The only thing that has been ‘long in development’ is persistently ignoring and denying these and similar instances of fraud, waste, and abuse.”
As recently as May 4, the DeWine administration cut the latest check to Omega Healthcare Services, which has received nearly $6 million through Medicaid, and is run by a woman who previously had a daycare shut down for not being able to prove the kids were real. Her husband and office-mate was convicted of billing the government for nonexistent elder services, and the company listed the teenage son of a convicted money launderer on corporate documents.
U.S. Rep. Brandon Gill (R-TX), who on Wednesday was named the chair of a new congressional subcommittee on fraud, said investigating Ohio is at the top of his list, and expressed shock at the lack of oversight of the multi-billion dollar program.
“Our first action: a formal investigation into a massive Medicaid fraud scandal in Ohio — where hundreds of shell companies operating out of empty office buildings billed taxpayers over $250 million for services that could not be verified,” Gill said. “And we believe the full scope of this scandal reaches into the billions.”
“A @realDailyWire reporter found this in two months. The agency responsible for stopping it had years,” he wrote.
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