Kudos for focus on reimbursement fraud

As officials at the federal level go on and on about reducing spending on Medicare and Medicaid by eliminating fraud, waste and abuse, officials at the state level are showing they've already been working diligently on that front. Earlier this month, the office of Ohio Attorney General Dave Yost filed indictments against nine Medicaid providers accused of stealing a total of $1.2 million from the program. These suspects are home health aides and mental health specialists who are accused of billing Medicaid for services they did not actually provide. One suspect, James Ferguson, 28, of Cleveland, allegedly claimed reimbursement for regular shifts of 16 hours of services per day for each of his six clients. Investigators say they discovered not only that he never provided 16 hours of services in a single day to any of those clients; but two clients reported that after an initial visit Ferguson never provided additional services at all. The total loss to Medicaid in that case was $724,966. Other allegations range from a person in Columbus who billed for in-home services while the client was hospitalized to a person in Maple Heights who billed for 93 days during which flight records reportedly show she was actually traveling to Florida, Missouri, Nevada, Pennsylvania, South Carolina and the Dominican Republic. That loss to Medicaid was $366,950. "Medicaid fraud is both a crime and a moral offense," Yost said. "It steals from the vulnerable and undermines our values as a society." The Ohio Medicaid Fraud Control Unit is working hard to track down thieves and preserve public money. For fiscal year 2025, it received more than $15.43 million in federal money (and more than $5.1 million in state funding) to do so. If the focus really is on reducing spending on Medicare and Medicaid by stopping this kind of theft, then our state level investigators must also be among those who do not see a reduction in federal support. THEY are doing exactly the job the public expects of them. Ogden Newspapers