Family Caregivers Remain Protected in Ohio, But Oversight Efforts Continue

Family caregivers in Ohio can breathe a sigh of relief. House Bill 795, originally introduced as the SHIELD Act and later renamed the Medicaid Program Integrity and Fraud Prevention Act, generated significant concern among advocates, providers, and families who feared it could effectively eliminate Medicaid reimbursement for many family caregivers. The proposal failed to advance, meaning family members will continue to be eligible for payment under Ohio's Medicaid waiver programs.

While supporters of the legislation argued that stronger safeguards were needed to combat Medicaid fraud and abuse, opponents warned that the bill could worsen caregiver shortages and reduce access to care for seniors and individuals with disabilities who rely on family members for daily assistance.

Although the Ohio proposal did not move forward, the debate reflects a broader trend that Indiana providers know well. Indiana has increased scrutiny of Medicaid-funded home care services through audits, documentation reviews, and program integrity initiatives aimed at identifying improper payments and fraud. While these efforts serve an important purpose, some family caregivers and providers have found themselves caught in the crossfire of heightened enforcement efforts.

For home care and home health agencies that employ family caregivers, compliance remains critical. Agencies should ensure caregivers receive proper training on documentation requirements, maintain accurate service records, conduct routine internal audits, and closely monitor electronic visit verification systems. Regular supervisory visits and ongoing compliance education can also help reduce risk during state audits and reviews.

The challenge for policymakers is finding the right balance between protecting Medicaid dollars and preserving access to care. Family caregivers play an essential role in helping older adults and individuals with disabilities remain safely at home. As states continue to focus on Medicaid integrity, providers must remain vigilant while advocating for policies that support both accountability and family caregiving.