A new version of an anti-fraud bill would ban family members from being paid by Medicaid to offer personal care services to disabled Ohioans. Dozens of disabled people and their advocates packed a House committee hearing late Wednesday to share their frustrations and fears over dramatic changes to Medicaid and home health care.
House Bill 795, known as the Safeguarding Healthcare Integrity through Electronic Location Data or SHIELD Act, has already been changed once before. Republicans on the Ohio House Medicaid Committee accepted a substitute bill that would prohibit family members from being paid by Medicaid for personal caregiving, and increases mandatory fines for Medicaid fraud ranging from $1,000 to $15,000. The bill still requires electronic visit verification or EVV, and would put new restrictions on home health care providers and suspend payments to suspect providers. The substitute bill doesn't include provisions related to publicly funded child care, which had been included in the earlier version of the bill.
People in wheelchairs crowded into the House Medicaid Committee room for two and a half hours to stress the need for caregivers so they can live at home. Speakers said if family members who apply for waivers can’t be paid, then thousands more paid caregivers will be needed or more disabled Ohioans could end up in costly long-term care facilities such as nursing homes. People who go through the waiver process to be paid through structured family caregiving programs are among those providing home health care services in Ohio, but most family members who are caregivers are unpaid.
Jennifer Kucera of the Ohio Olmsted Task Force, a disability advocacy group, told lawmakers she knows they want to get the bill passed soon, but they need to take more time with it.
"You really have to study the system. You have to talk to the people that know the system and get everybody's thoughts on it. And getting these three minute, five minute testimonies are just simply not enough time," Kucera said. "I know you want to get this done. And I know you said you've been working on this, but it's not a thing that you can rush through because there will be human damage."
Justin Martin of the Columbus area is a teacher who has cerebral palsy and uses a wheelchair. He said he’s had trouble hiring aides to help him with day-to-day activities so he can get to work and socialize with friends.
"I have to hear folks on this committee saying things like, 'oh, we're just here to protect the taxpayer' as if a) I'm not a taxpayer. I'm trying to work here. I need to be able to be dressed to do that and b) I'm fine with safeguarding the taxpayer. I just think we should start with the taxpayers who can't shower and dress themselves, which will eventually be all of your constituents," Martin said.
Republicans have said changes must be made to the system as it is to halt hundreds of millions of dollars in Medicaid fraud. This follows a report from a conservative national outlet of widespread fraud among home health providers in Ohio, though the state hasn’t fully confirmed or offered details. Some speakers cast doubt on the claims from the Daily Wire, and said they were concerned the state was so quickly embraced that reporting.
Republicans have controlled state government since 2011. Legislative leaders have blamed Gov. Mike DeWine and his former Medicaid director Maureen Corcoran for not doing more to halt fraud. DeWine put out a list of initiatives in response to the report, including a six-month moratorium on new providers and a mandatory GPS requirement for EVV.
"We will not be moving forward with business as usual when we have up to $6-8 billion of fraud in our system," said committee chair Rep. Jennifer Gross (R-West Chester). 'When we spend the money that we shouldn't be spending for people who should not receive services, a lot of the people in this room then suffer because they don't get the services they deserve. And so we need to stop those receiving care that should not be receiving care. And we need to provide for those who definitely do need the care."
HB 795 hasn’t been voted out of the House Medicaid Committee, but that could happen next week.
