Ohio Medicaid leaders urge tougher tools, wider data use to fight fraud

The joint House and Senate Medicaid committees heard presentations from Ohio Department of Medicaid Director Scott Partika, Attorney General Yost and Auditor Faber on efforts to detect and prevent fraud, waste and abuse in the state’s Medicaid program.

Scott Partika told lawmakers the department is building program integrity into day‑to‑day operations, using a mix of audits, provider enrollment controls and data analytics. He said federal data sharing helped the department identify “about 6,000” people without verifiable claims history and that those records were moved from managed care to fee‑for‑service while the department seeks documentation. "We removed them from managed care and put them on fee for service to monitor while they received the notice to provide the additional information," Partika said.

Why it matters: committee members pressed for details on…