Rep. Mike Dovilla Testifies Before Congress Regarding Medicaid Oversight

State Representative Mike Dovilla (R-Berea) today testified before the U.S. House of Representatives Task Force on Defending Constitutional Rights and Exposing Institutional Abuses regarding Ohio's ongoing efforts to improve accountability, strengthen eligibility verification, and combat fraud within the Medicaid program.

Dovilla's testimony detailed a year-long investigation into Ohio's Medicaid eligibility verification processes, which began after concerns were raised by a constituent regarding potential weaknesses in the state's oversight of the Aged, Blind, and Disabled (ABD) Medicaid eligibility category.

"Throughout my career, I have worked to increase accountability and transparency in government as a steward of taxpayer dollars," said Dovilla. "Medicaid must be preserved for those who genuinely need it - low-income families, expectant mothers, seniors, individuals with disabilities, and others who depend on a functioning safety net. But a safety net cannot work if it becomes a target for fraud, waste, and abuse."

Following inquiries by Dovilla's office in 2025, questions emerged regarding how eligibility concerns identified through third-party verification systems were being reviewed and resolved. In response, Dovilla introduced House Bill 356, legislation requiring enhanced cooperation between the Ohio Department of Medicaid and the Auditor of State to conduct a comprehensive audit of Medicaid eligibility within the ABD population.

The legislation was ultimately incorporated into Ohio's biennial operating budget and became law in 2025.

During his testimony, Dovilla emphasized the importance of the ongoing audit process and highlighted concerns raised by Ohio Auditor of State Keith Faber regarding difficulties obtaining complete and reliable data necessary to conduct a thorough review.

"If the data are hard to obtain, incomplete, inconsistent, or poorly organized, then lawmakers, auditors, and taxpayers cannot have full confidence that eligibility and payment decisions are being properly monitored," Dovilla testified. "That is exactly why the audit is essential."

Dovilla also discussed concerns surrounding Medicaid provider oversight, including reports of unusually high Medicaid billing activity among clusters of home health and personal care service providers operating from a limited number of commercial locations in Columbus.

Throughout the question-and-answer portion of the hearing, several Congressional Democrats focused their remarks on the Trump Administration and broader political issues rather than the specific evidence of fraud, waste, and abuse presented by witnesses. On multiple occasions, Democratic members interrupted Rep. Dovilla and other witnesses before they were able to complete their answers, limiting discussion of Medicaid eligibility verification, provider oversight, and the challenges Ohio has encountered in protecting taxpayer dollars and ensuring program integrity.

As a member of the Ohio House Medicaid Committee, Dovilla is currently working with colleagues on comprehensive Medicaid integrity legislation that would strengthen provider enrollment requirements, improve electronic visit verification systems, increase fraud reporting requirements, enhance oversight of high-risk providers, and establish stronger penalties for fraudulent activity.

"This should not be a partisan issue," Dovilla said. "Medicaid fraud harms taxpayers, legitimate providers, public servants, and most importantly the vulnerable individuals who depend on the program. Oversight is not cruelty. Verification is not extremism. Accountability is not partisanship. It is the minimum taxpayers expect and the minimum our most vulnerable citizens deserve."

Dovilla's testimony before the congressional Task Force on Defending Constitutional Rights and Exposing Institutional Abuses focused on lessons learned through Ohio's ongoing efforts to improve Medicaid program integrity and opportunities for greater accountability at both the state and federal levels.