COLUMBUS — Ohio Medicaid, which provides health care insurance for 1.7 million Ohioans, should make more than 100 changes, some of which would result in $403.5 million in savings, state Auditor Betty Montgomery said Tuesday.
Montgomery released an 800-page performance audit that her staff has been working on since October 2005.
The study takes the program to task for using antiquated technology, operating under a maze of conflicting, redundant bureaucratic rules, and failing to innovate as aggressively as other states. It also said Ohio recently expanded into managed care without strong empirical evidence that it'll hit expected savings.
Ohio Medicaid is a $13 billion a year program paid for and administered by 256 state, local and federal agencies. It serves low-income families with children and elderly and disabled Ohioans.
The audit recommends the following:
• Set nursing home reimbursement rates through administrative rules instead of legislative changes.
• Require county agencies to use electronic documents instead of paper for Medicaid recipients.
• Pilot using electronic prescribing of medications.
• Require Medicaid providers to electronically submit their claims for payment.
• Require providers who have been investigated for fraud post surety bonds.
• Establish an inspector for Medicaid to root out waste, fraud and abuse.
