Ohio’s Aggressive Medicaid Estate Recovery Sparks Debate Over Policy Changes
Ohio’s approach to recouping Medicaid expenses from the estates of deceased recipients has sparked a heated debate over policy changes. A recent investigation by the Dayton Daily News found that Ohio is more aggressive than most states in pursuing Medicaid recovery, leading to calls for reform from advocacy groups and some members of Congress.
Unlike many states, Ohio puts liens on the properties of Medicaid recipients, which can result in families being forced out of their homes after their loved ones pass away. Additionally, Ohio is among the few states that pursue recovery for non-Long-Term Service and Support benefits, including debts from medical visits and procedures. This aggressive approach has drawn criticism from advocates for seniors, who argue that it disproportionately affects individuals with limited means, potentially perpetuating intergenerational poverty.
A study conducted by the Medicaid and CHIP Payment and Access Commission (MACPAC), an advisory group to Congress, found that Ohio’s Medicaid estate recovery program does not have cost-effectiveness tests or predetermined thresholds for property value. This lack of clear guidelines has led to concerns about inconsistent enforcement and potential abuses of power. MACPAC has recommended making estate recovery optional for certain populations and services.
Despite the concerns raised by advocates, Ohio officials argue that their current laws governing Medicaid recovery are sufficient. The Ohio Attorney General’s Office has been aggressive in its efforts, recovering over $270 million since 2019. These collection efforts have made Ohio one of the top states in Medicaid recovery, surpassing even larger states in total collections.
Critics argue that the current system relies too heavily on the discretion of the attorney general and lacks transparency and accountability. Advocacy groups, such as Pro Seniors Inc., have called for a more standardized and fair process that is based on clear rules and regulations, rather than being driven by individual interpretations.
Ohio’s Medicaid estate recovery program has also faced scrutiny for its collection of personal needs accounts from nursing home residents. Small amounts remaining in these accounts are automatically sent to the state, raising concerns about the financial burdens placed on vulnerable individuals.
In response to the criticisms, Ohio officials have made efforts to improve understanding of estate recovery among Medicaid applicants. They have inserted estate recovery forms in approval and change notices and updated the Ohio Benefits self-service portal to provide more information on the process. However, advocates argue that these changes do not address the fundamental issues with the aggressive nature of Ohio’s approach.
The debate over Ohio’s aggressive Medicaid estate recovery policy highlights the need for a comprehensive and balanced approach to recouping Medicaid expenses. While the program is intended to ensure the responsible use of taxpayer funds, it is crucial to consider the potential impact on vulnerable individuals and the wider community. As discussions continue, advocates and policymakers will need to find a solution that strikes a balance between fiscal responsibility and the protection of those who rely on Medicaid for their healthcare needs.
