In a survey released this morning by Scioto Analysis, 6 of 13 economists indicated that Medicaid fraud prevention programs that increase penalties and require additional verification and inspections will create fiscal savings that outweigh the administrative costs of running them.
Earlier this month, Medicaid provisions were added to Senate Bill 315 to reduce fraudulent claims by increasing penalties, requiring electronic video verification, and increasing inspections. As of June 29, Senate Bill 315 has passed both the House and Senate and is now on Governor DeWine’s desk awaiting his signature.
Six economists agreed that Medicaid fraud programs would create fiscal savings that outweigh their costs.Two economists were uncertain, 4 economists disagreed, and 1 had no opinion. Michael Jones of the University of Cincinnati explained, “a low-cost verification system that confirms identity and eligibility at the moment that services are provided should produce a positive ROI for Ohio. Ohio should be implementing electronic visit verification for nearly every service that is reimbursed. Unfortunately, AI and other economic forces are moving us from a high-trust to a low-trust society; and reasonable checks and inspections can help restore societal trust in government services.”
5 of 13 economists were uncertain about the impacts of Medicaid fraud prevention programs on access for vulnerable populations like people with disabilities. According to Jonathan Andreas of Bluffton University, “It will undoubtedly reduce access in the short run because of inevitable false positives which reduce necessary care, but in the long run, IF it increases the efficiency of Medicaid, it could increase care because of helping channel scarce dollars to the patients who really need them rather than to fraudsters.” Of the remaining economists, 3 agreed that fraud prevention programs would reduce access, and 3 disagreed.
5 of 13 economists disagreed that Medicaid fraud prevention programs will generate a greater economic return than expanding benefits for recipients, with another 5 economists uncertain. According to Charles Kroncke of Mount Saint Joseph University, “I doubt the financial return of the program will exceed its expenses. In addition, there will be a social cost of vulnerable populations losing benefits.” Of the economists who were uncertain, many expressed it is difficult to estimate how fraud prevention will impact the efficiency of Medicaid.
The Ohio Economic Experts Panel is a panel of over 30 Ohio Economists from over 30 Ohio higher educational institutions conducted by Scioto Analysis. The goal of the Ohio Economic Experts Panel is to promote better policy outcomes by providing policymakers, policy influencers, and the public with the informed opinions of Ohio’s leading economists. Individual responses to all surveys can be found here.
