CMS Targets Ohio Healthcare Fraud, Suspending 49 Home Healthcare Providers

So today we have three major announcements from the healthcare part of this fraud endeavor. The first is that the state of Ohio, and I want to applaud the Medicaid office here, they will be announcing at 1 o'clock, and please pay attention to that important announcement, that they are suspending 49 home healthcare providers who have been identified as high risk to the Medicaid program. These people have built millions of dollars to take advantage of our most vulnerable, and if you're willing to steal from folks who are down and having a difficult time, you'll not just steal their money, you'll steal their health, you'll steal their lives, and we're seeing that. No more champagne on private jets for these people, no more new cars, no more luxury endeavors and vacations, it's done. We're coming after you wherever you are, and as Attorney General Blanch highlighted, we are earnest and serious in this endeavor, we will not be daunted. Ohio Governor DeWine also sought a six-month moratorium for all new home healthcare and hospice in the state of Ohio. We granted that within a day, and we hope that will help at least slow the bleeding, using a surgical metaphor, so we can get a bandage on the wound, maybe put a couple stitches in and take out some of the folks who have been stabbing the patient of Medicaid. Second big announcement. In order to solidify collaboration, CMS, Medicare, Medicaid, and Ohio are going to launch a state-specific Medicaid fraud room. It's going to copy the Medicaid fraud room created at the federal level by the task force The findings surfaced through this state partnership, we believe, will free us to be able to directly collaborate at a national level, getting all states to understand what the problems are within their areas, and accelerating our ability to take out high-risk providers. We'll identify them, and we'll enforce actions around them. The applied behavioral analysis process, it's called ABA therapy for autism, has been scandalously abused. This is, again, taking advantage of children with autism, or getting their parents to lie about whether the child has autism, or weakening the system so the kids who actually need the services can't get them anymore. There are nine providers who were paid more than a million dollars to do this last year, these ABA services. We're going to go after them, we're going to deny some of the issues. In fact, two of these people were denied access to Medicare already. They should never have been in the Medicaid program. The top provider earned over $3 million. That's twice the closest competitor, and remember, the average provider of autism services gets paid around $200,000. So to have someone pay over $3 million is shocking. And the World Room that's created with Ohio will be opening investigations on two home health care providers, and this World Room is going to yield huge benefits. And finally, we want to speak a little bit about the fact that we have the need to audit states all over the country to help states understand where they are in comparison to all the other states. We don't have a national effort that allows states to at least get a best practices idea from surrounding areas. So we have now, and I can announce today, asked the state of Indiana to work with Oracle Health to provide that exact set of information. So all the states now will be armed with information, for example, on high-risk providers. And the ABA therapy, autism, as I mentioned before, we've asked all 50 states to revalidate these providers and other high-risk categories. Every single state has agreed. By this Friday, they're obliged to provide us with a specific plan. But if you're involved in some high-risk endeavor, these are endeavors that are unlicensed individuals often in unsupervised settings, we want the states to go back and check who you are. We're not paying fraudsters for dishonest endeavors that hurt the American people.