Ohio’s DeWine Just Announced Fraud Prevention Initiatives—Are They Enough?

With Ohio facing scrutiny over Medicaid fraud, Gov. Mike DeWine on Wednesday announced a series of new prevention measures from Ohio Department of Medicaid—but critics question if it’s enough.

The announcement from the governor’s office noted the initiatives are meant “to strengthen and build-upon long-standing efforts to fight fraud, waste, and abuse in the Ohio Medicaid system.” The governor also touted the state’s efforts thus far and thanked the Trump administration for its cooperation.

DeWine has instructed the Ohio Department of Medicaid (ODM) to place a moratorium on new home-health care and hospice businesses seeking to be Medicaid providers, and to immediately suspend payments to “high-risk” providers whose billing practices are suspected of fraud.

The department also will implement emergency rules requiring frequent revalidation of providers identified as being at higher risk of committing fraud.

Finally, ODM will require GPS for all providers using Electronic Visit Verification (EVV) and will begin a rulemaking process for having live-in caregivers use the verification technology while working, as a prerequisite to receive payments.

“The Ohio Department of Medicaid fully supports and appreciates Governor DeWine’s commitment to strengthening program integrity and defending Medicaid members and taxpayers,” Stephanie O’Grady, ODM’s chief communications officer, told The Daily Signal.

O’Grady said the department has been “actively expanding its program integrity capabilities, including upgraded data analytics, enhanced provider screening, and new safeguards for high-risk services.”

She also pointed to how the initiatives build on current efforts involving prior authorization, expanded analytics, and collaborations. “ODM will continue to act decisively whenever concerns arise and will not hesitate to remove, suspend, or refer any provider who attempts to exploit the Medicaid program,” O’Grady added.

DeWine shared his announcement on X, which then drew strong reactions on the platform, including from Republican state Rep. Mike Dovilla.

According to a report by the Columbus Dispatch, Senate President Rob McColley, Vivek Ramaswamy’s pick for lieutenant governor, also questioned the seemingly late timing of the fraud response.

“We’ve received tremendous resistance from the Department of Medicaid when the Legislature’s tried to step in and tried to offer its own oversight,” McColley is quoted as saying.

Other lawmakers, including Republican House Speaker Matt Huffman, noted the governor’s past vetoes of fraud legislation.

Dan Tierney, spokesperson for DeWine’s office, addressed those criticisms in a statement to The Daily Signal.

“Regarding the veto of the additional audit, Ohio Auditor of State Keith Faber had conducted numerous audits of Ohio Medicaid since that provision was vetoed as duplicative. A second category of vetoes involved access to information that our legal team determined was prohibited by federal law,” Tierney said.

“Lastly, I am familiar with the veto of the prohibition of implementing universal GPS for EVV. Absent that veto, we would have been statutorily prohibited from seeking that change during yesterday’s announcement.”

Faber has been vocal about his efforts to tackle fraud and applauded Dovilla for his efforts. Though Faber’s term as auditor is ending, he is running for attorney general.

Tierney referred to Faber as “very effective in auditing state agencies, including Ohio Medicaid,” and added, “we appreciate his collaborative approach in state agency audits.”

Allegations of fraud have national implications. U.S. Rep. Brandon Gill, R-Texas, announcing he will be heading a taskforce. This follows President Donald Trump’s decision in March to create a new task force to eliminate fraud headed by Vice President JD Vance.

Mehek Cooke, a legal and national security analyst with The Daily Signal, has also been speaking out about Ohio fraud, which she also addressed in a recent appearance on Fox News.