Public Assistance Reporting Information System Alerts
Learn how the AI-generated research projects were createdOverall Conclusion
Based on the sampling results, 59% of PARIS alerts were not worked or not worked timely; this undermines the effectiveness of PARIS in controlling improper capitation payments. The Department’s corrective actions and monitoring efforts are ongoing, and the audit results support the recommendations.
Source Document
Audit Scope
PARIS alerts generated in June, September, and December 2021. Sample of 330 alerts across three counties (Cuyahoga, Franklin, Summit). Review of Ohio Benefits, MITS, verification letters, residency determinations, and capitation payments for improper payments.
Key Findings Summary
CDJFS caseworkers did not work a substantial portion of the PARIS alerts, which has a significant impact on Ohio’s Medicaid program.
Not working and not timely working PARIS alerts could have a potential impact on the Ohio Medicaid program between $5.3 million and $24.5 million.
Of the 330 sampled PARIS alerts, 194 contained errors (59% error rate): 158 alerts not worked at all and 36 not worked timely.
View the Findings tab to see all 8 findings
AI-Assisted
AI Scope Summary
This audit focused on three objectives: (1) whether CDJFS caseworkers processed PARIS alerts timely, (2) whether CDJFS caseworkers timely dis-enrolled ineligible recipients or those not responding to verifications, and (3) whether the Department recouped improper capitation payments related to PARIS alerts. The scope included PARIS alerts generated in June, September, and December 2021, with a 330-alert sample across three counties. The findings indicate substantial unworked or untimely alerts, with estimated potential financial impact ranging from $5.3 million to $24.5 million annually, supporting ongoing Department actions to improve PARIS processing.
AI-Generated Insight
The PARIS Alerts audit reveals significant operational gaps in alert processing, verification, and residency determination, exposing potential multi-million-dollar financial risk to Ohio’s Medicaid program. Key remedies include enhancing system logic, adding due dates to notices, strengthening county monitoring, and updating processing guides and training.
Audit Objectives
Confirming whether CDJFS caseworkers worked PARIS alerts timely.
Vouching whether CDJFS caseworkers timely dis-enrolled recipients identified by the PARIS alert system to be ineligible for Ohio Medicaid because they were concurrently eligible and residing in another state or did not respond to verification notices.
Confirming whether the Department recouped improper capitation payments related to PARIS alerts.
Audit Findings (8)
CDJFS caseworkers did not work a substantial portion of the PARIS alerts, which has a significant impact on Ohio’s Medicaid program.
Not working and not timely working PARIS alerts could have a potential impact on the Ohio Medicaid program between $5.3 million and $24.5 million.
Of the 330 sampled PARIS alerts, 194 contained errors (59% error rate): 158 alerts not worked at all and 36 not worked timely.
There were 13 instances where the alert was worked but not within the required timeframe and the recipient was determined to be a non-Ohio resident; identified over $16,091 in improper capitation payments.
For 199 of the 330 sampled alerts (60%), no initial verification letter was sent by the CDJFS and an additional six instances where a subsequent verification letter was not sent.
Finding for Recovery: $16,091.
The results indicate that 59% of PARIS alerts were not worked or not worked timely; this supports ongoing concerns about the PARIS process.
The Department identified recommendations to improve the PARIS alert process including monitoring, training, updating guides, and reviewing sampled alerts for possible recoupments.
Recommendations (4)
Evaluate Current PARIS Alert Process and the Ohio Benefits System: evaluate enhancements, obtain CDJFS input, consider adding due dates and automate verification letters, address repeated alerts and the heavy county workload.
Monitoring and Technical Assistance: follow the monitoring plan monthly, provide assistance to counties for processing PARIS alerts.
PARIS Alert Processing Guide and Training: update the PARIS Alert Processing Guide and hold annual PARIS alert training.
Review the Sampled PARIS Alerts: review non-worked alerts to verify residency and recoup any capitation payments where appropriate.