Mike DeWine signs Medicaid provider fraud crackdown bill

Gov. Mike DeWine signed Senate Bill 315 into law, imposing new Medicaid provider rules, stiffer fraud penalties, and chip-enabled SNAP cards after Ohio lawmakers fast-tracked the bipartisan package in June. Supporters say the law protects taxpayers; critics warn prior authorization could delay home-based care.

The signing follows months of scrutiny over alleged fraud in Ohio's growing Medicaid program. What began as legislation to upgrade Supplemental Nutrition Assistance Program cards gained major Medicaid provisions when the Ohio House Finance Committee attached them just before passage, according to the Dayton Daily News. The result is one of Ohio's most significant recent moves to tighten oversight of public-benefit spending — a theme we track in our Fintech & Crypto Alerts coverage.

Key Takeaways

• Senate Bill 315 adds Medicaid provider verification, prior authorization, and electronic visit verification requirements.
• Medicaid fraud penalties rise to felony levels, and fraud can be prosecuted under Ohio's Corrupt Activities Law.
• The bill also mandates chip-enabled SNAP cards to reduce skimming and benefit theft.
• A panel of 13 Ohio economists is split on whether fraud-prevention savings will outweigh administrative costs.
• Disability advocates and some providers warn the rules could delay or disrupt home-based care.

What did Mike DeWine sign into law?

DeWine signed Senate Bill 315, which layers new regulations onto certain Medicaid providers while preserving the bill's original SNAP security upgrades. Lawmakers passed it in June after folding in provisions from House Bill 795, an earlier Medicaid fraud-prevention measure.

A controversial HB 795 proposal to ban payments to family caregivers was removed and did not carry into the final law. State Rep. Josh Williams, R-Sylvania Twp., a cosponsor, said the law puts "fraudsters and criminals on notice" that Medicaid abuse will draw serious prosecution. Ohio Attorney General Andy Wilson told the Dayton Daily News the bill gives investigators "a variety of tools" to pursue cases.

What new rules will Medicaid providers face?

Proponents say the added rules protect taxpayer dollars. Providers must verify certain visits and services through electronic visit verification software. The Ohio Department of Medicaid must suspend payments when the attorney general or state auditor submits a credible fraud allegation, per the Ohio Capital Journal.

The law also requires electronic verification of home-care visits when the provider does not live in the recipient's home, and it includes whistleblower protections. Critics say required prior authorization under home- and community-based waivers could cause care delays. The Department of Medicaid must intervene if authorization drags on, but some providers say even a week-long wait could disrupt services.

Penalties escalate sharply: Medicaid fraud becomes a fifth-degree felony rather than a first-degree misdemeanor, with higher felony tiers and fines for larger dollar amounts. Fraud also qualifies as corrupt activity, allowing prosecution of connected networks as ongoing criminal enterprises.

Will the crackdown save money or block care?

When Scioto Analysis surveyed 13 Ohio economists, opinions were divided. Five agreed fraud-prevention programs with tougher penalties and added verification would produce fiscal savings exceeding administrative costs; four disagreed and three were uncertain or had no opinion.

On whether the rules would reduce access for vulnerable populations, four agreed, four disagreed, and five were uncertain. Disability rights advocate Maria Matzik, who relies on Medicaid home- and community-based services, testified that the approach emphasizes "suspicion, surveillance and fraud enforcement" over helping people live at home.

State Sen. Willis E. Blackshear Jr., D-Dayton, a cosponsor, acknowledged "significant misinformation and exaggeration" around Medicaid fraud but backed enhanced oversight. He said lawmakers must monitor fast-tracked changes to ensure they do not create unintended consequences for providers and patients.

What does Senate Bill 315 mean for SNAP recipients?

The law's original core requires transitioning Ohio SNAP cards to chip-enabled versions. Chips generate encrypted, unique transaction codes — unlike magnetic-strip cards that are vulnerable to skimming. Blackshear said the upgrade should help reduce scams and benefit losses for families who rely on SNAP.

Combined with Medicaid enforcement tools, the package reflects bipartisan pressure to shore up two of Ohio's largest safety-net programs at a moment when program integrity and payment security are drawing national attention.