OH · Medicaid jurisdiction

Ohio Medicaid audit evidence

Review reports connected to Ohio Medicaid oversight, ordered by publication date.

Evidence register

5 reports

Published: Nov 1, 2024
Jurisdiction: Ohio

Publishing agency: Ohio Auditor of State
Report ID: REPORT 22

Electronic Visit Verification Audit Ohio Department of Medicaid

The audit identified significant gaps in EVV utilization and matching, with only 44% of claims supported by EVV data in 2022. The Department has made efforts to implement EVV but faces challenges including low provider compliance, technical issues, and stakeholder engagement.…

Findings: 5
Recommendations: 3

Open evidence record

Source status: Original source

Published: Dec 13, 2022
Jurisdiction: Ohio

Publishing agency: Auditor of State of Ohio
Report ID: REPORT 153

Public Assistance Reporting Information System Alerts

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 suppor…

Findings: 8
Recommendations: 4

Open evidence record

Source status: Original source

Published: Dec 28, 2021
Jurisdiction: Ohio

Publishing agency: Auditor of State of Ohio
Report ID: REPORT 152

Improper Capitation Payments

The Department has processes to identify and recoup improper capitation payments, but controls are not sufficiently robust to ensure all improper payments are identified and recouped. The audit identified over $118.5 million in improper capitation payments not recouped for SFY…

Findings: 7
Recommendations: 5

Open evidence record

Source status: Original source

Published: Feb 15, 2008
Jurisdiction: Ohio

Publishing agency: Ohio Auditor of State
Report ID: REPORT 24

Audit of Medicaid Reimbursements Made to Regency Manor Rehabilitation

The audit identified overpayments totaling $58,540.97 due to billing inaccuracies in room and board, and therapy services. The provider is responsible for repayment, and the Department of Job and Family Services will make final determinations regarding recovery.

Findings: 3
Recommendations: 2

Open evidence record

Source status: Original source

Published: Jun 29, 2000
Jurisdiction: Ohio

Publishing agency: Ohio Auditor of State
Report ID: REPORT 19

Review of Medicaid Provider Reimbursements made to Crest Transportation Service

The review identified significant non-compliance with Medicaid reimbursement rules by Crest Transportation Service, resulting in overpayments and raising concerns about potential fraud and abuse. The provider’s documentation deficiencies, billing irregularities, and the owner’…

Findings: 8
Recommendations: 4

Open evidence record

Source status: Original source