Public Assistance Reporting Information System Alerts

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.

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.