Republican gubernatorial candidate Vivek Ramaswamy pitched ways to “crush” reports of Medicaid fraud that fellow leaders say Gov. Mike DeWine’s administration allowed to fester.
Ramaswamy proposed working with federal leaders to bring more Medicaid savings back to Ohio, increasing prosecution of Medicaid fraud and simplifying how Medicaid is administered.
“When you have criminals, fraudsters, thieves claiming money for themselves, it diverts money away from those for whom these programs were intended, and that’s a problem,” said Ramaswamy, who is running to replace DeWine. He added that solutions are possible: "This is a question of political will and prioritization."
Ramaswamy estimated that Ohio could save $3.1 billion through these efforts to pay for copay assistance, reduce health care premiums and assist with health savings accounts.
Ohio Medicaid isa state and federally funded health care program for low-income peopleand those with disabilities. Roughly 3 million Ohioans are on Medicaid, which costs $43 billion a year.
Among the changes, Ramaswamy proposed:
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Requesting a federal waiver that would allow Ohio to keep at least two-thirds of the dollars in Medicaid savings instead of the current 35 cents. He would model this change on Tennessee’s shared savings waiver.
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Simplifying how Medicaid is administered. Currently, about $47 billion in Medicaid funding flows through 10 agencies.
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Increasing prosecution of Medicaid fraud, which has already led to 110 criminal convictions and 39 civil settlements between 2021 and 2025.
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Supporting work requirements for Medicaid that were included in President Donald Trump's "One Big Beautiful Bill."
His proposal comes after top Republican lawmakers blamed DeWine for allegations of home health care fraud reported in theconservative Daily Wire. The articles have promptedstateandfederalinvestigations.
Home health care allows patients to receive nursing and other services in their homes rather than in a nursing facility. Sometimes the caregivers are also relatives.
Fraud convictions are more common in home health care and behavioral health because there's a low barrier for entry into the job and providers operate largely unsupervised, Ohio Attorney General Dave Yost said duringa March legislative hearing.
Republicans trade blame over Medicaid issues
DeWine and fellow Republicans aren't seeing eye to eye on the scope of Medicaid issues. DeWine says Ohio is a national leader in fraud detection and prosecution. Legislative leaders accuse DeWine's team of falling down on the job.
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“When you have a director who simply isn’t going to follow the law, you have the kinds of catastrophes that we have right now," Ohio House Speaker Matt Huffman said of ex-leader Maureen Corcoran.
Ohio Auditor Keith Faber, who is running for state attorney general, said he’s been flagging issues within Medicaid, particularly in home health care and behavioral health, for years.
“Many of the things that have recently been identified are not new to us,” Faber said.
Republican lawmakersrecently killed a committee that oversaw Medicaidspending and shifted those responsibilities to other committees. Huffman said that the committee wasn't effective in getting to the bottom of the issue and Ramaswamy said the answer isn't more committees.
“We require a leader at the top who is willing to speak that hard truth and to act on that hard truth,” he said during a May 19 news conference.
What has DeWine done?
Since last week, DeWine has proposed a slew of Medicaid fixes,including a six-month moratorium on new home health care and hospice businessesbecoming Medicaid providers. Meanwhile, Vice President JD Vanceannounced a halt to new Medicare enrollment for those businesses.
On May 18, DeWinesigned an executive orderto require Medicaid providers at higher risk of fraud to revalidate enrollment more frequently. The order would also allow Medicaid to cancel providers that had not billed the program in more than a year.
DeWine also reinstated a GPS requirement when providers log their caregiving online. Yost questioned why GPS wasn't required during a March legislative hearing.
State government reporter Jessie Balmert can be reached at jbalmert@usatodayco.com or @jbalmert on X.
This article originally appeared on The Columbus Dispatch:Ramaswamy targets Medicaid fraud in Ohio, blames DeWine’s oversight
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