Ohio launched a series of new oversight measures for behavioral health providers and programs amid concerns about fraud, abuse and accountability, according to a June 2 news release from the Ohio Department of Behavioral Health.
Here are six things to know:
- New provider applications face additional scrutiny. The Ohio Department of Behavioral Health implemented an enhanced review process for new behavioral health provider licensure and certification applications, including a temporary freeze on new behavioral health and rehab provider applications.
- The state is increasing anti-fraud efforts. The behavioral health department said it will strengthen coordination with the Ohio Department of Medicaid, managed care organizations and the Ohio attorney general to identify and address potential fraud, waste and abuse.
- Provider oversight is expanding. The department is reinforcing provider renewal requirements and increasing verification and monitoring of service delivery and program performance.
- A statewide monitoring framework is being implemented. The framework aims to establish standardized reporting requirements, monitoring tools, corrective action procedures and documentation practices for DBH-funded programs and partners.
- A recent federal case highlighted fraud concerns. On June 4, four people were charged in federal court in Ohio in what authorities described as a $30 million fraud conspiracy involving billing for children’s behavioral health services that were not provided.
- Current providers can continue operating. Existing provider operations, authorizations and ongoing services are not affected by the enhanced review process, the release said.
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