Ohio Medicaid Head to Depart Ahead of Auditor’s Contract Probe

The director of the Ohio Department of Medicaid plans to leave her post next month as the agency faces scrutiny over its multibillion dollar contracts with the nation’s largest processor of Medicaid claims.

Maureen Corcoran, who has led Ohio Medicaid since the beginning of Gov. Mike DeWine’s (R) term in 2019, will be departing after Oct. 31, a press release from the governor’s office announced.

“Maureen has served the people of Ohio well throughout her career in public service, and I am grateful to her dedication and commitment to her fellow Ohioans,” DeWine said in a statement.

The reason for her departure remains unclear, but comes more than a year before the end of DeWine’s final term and as the Ohio Auditor of State is readying an extensive probe into Ohio Medicaid’s programs.

The announcement follows Bloomberg Law’s reporting this month that top legislative negotiators quietly slipped a provision into the state budget disbanding the Joint Medicaid Oversight Committee, or JMOC, after it had spent months questioning Ohio Medicaid officials on issues including delayed reimbursements to hospitals, skilled nursing facilities, and other health centers that threatened their ability to pay employees and treat patients.

The committee’s inquiries centered on programs operated with the help of claims contractor Gainwell Technologies LLC. Gainwell operates in approximately two-thirds of US states, and in Ohio it has contracts to operate the Medicaid program’s centralized claims payment system and manage prescription drug benefits, among other responsibilities.

Bloomberg Law previously reported that Gainwell had moved some of its work for Ohio Medicaid to India, despite contract provisions and a governor’s executive order prohibiting such offshoring without explicit approval. Ohio Medicaid gave that approval after Gainwell had already hired employees in India to work on the state’s contracts. The offshoring took place without the knowledge of top lawmakers from JMOC and the Ohio legislature’s standing Medicaid committees.

This all comes as the federal government has made it a mission to root out fraud and waste in the Medicaid program, passing nearly $1 trillion in cuts to the federal-state program providing health coverage for roughly 70 million low-income and disabled Americans.

Health-care providers and others have complained for years of delayed payments and systems issues with Gainwell’s Ohio programs. At the same time, Ohio Medicaid spending has continued to increase annually, with recent analysis to JMOC from a former top Ohio state official showing actual expenditures on the pharmacy benefits system outpaced initial projections by $585 million over the first nine months

Despite this, Ohio Medicaid has claimed massive savings to the state. Corcoran testified to JMOC in June that the first two years of the pharmacy benefits program resulted in $140 million in total savings, with administrative savings of more than $333 million.