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Ellen Belcher is the Dayton Daily News opinion pages editor. She writes about state government, education, the environment, higher education and all things Dayton.
Martin Gottlieb is an editorial writer and columnist for the Dayton Daily News opinion pages. He focuses on the political process itself and does such national issues as war, the economy, taxes and Social Security, as well as a hodge-podge of local and state issues.Home > Blogs > A Matter of Opinion > Archives > 2011 > February > 10 > Entry
Editorial: Whistle-blowers need state law on their side
It’s hard to predict what will get legislators off the dime.
But CareSource’s $26 million settlement last week for alleged Medicaid fraud is an attention-grabber for some politicians. The case may end up being the impetus to pass a stricter so-called “false claims” law that would complement the federal law that led to CareSource writing such a big check.
CareSource settled with the Department of Justice, the attorney general and private lawyers who accused the nonprofit of telling the state for six years that it had assessed special-needs children for medical care when it had not. CareSource made no admission in the settlement and denies any wrongdoing.
Republican Attorney General Mike DeWine says that Ohio would benefit from having a tougher state false claims law if only because federal law gives states a larger share of any fraud settlements or judgments if they have robust whistle-blower statutes of their own.
Noting that the federal false claims law dates back to Lincoln, Mr. DeWine said, “It’s not like someone dreamt up this yesterday. You need it.”
Iowa Sen. Charles Grassley (a Republican colleague of Mr. DeWine when he was in the U.S. Senate) has championed the idea that Washington needs to give states incentives to make sure that contractors — who often are being paid with federal money passed through the states — aren’t cheating.
To that end, Republican state Sen. Jim Hughes, of Columbus, has made runs at passing a broader false claims law, but hasn’t been successful so far. He said this week that, in the wake of the CareSource case, he’s pulled his old files from the legislative archives.
Among the current state law’s shortcomings is that pharmaceutical companies can’t be sued under it. Whistle-blowers aren’t protected against losing their jobs, and there is no provision for rewarding them financially. Finally, the attorney general can’t take statements under oath as part of his investigation.
If Ohio’s law had these sorts of provisions, the state could have gotten an estimated $1 million more — over and above its $10.2 million share — from the CareSource settlement.
Even putting the CareSource case aside, the time is right for Ohio to catch up with the estimated 27 states that have false claims laws that protect and give whistle-blowers a financial incentive to come forward.
Gov. John Kasich especially should be supportive of a comprehensive state false claims law. He believes that government can save money by privatizing certain services and leaning more heavily on the private sector.
If more responsibility — whether for running prisons or providing economic development services — is going to be farmed out, he should want to know that Ohio has checks and balances on the entities it relies on.
Hoping that government alone can police vendors and contractors is not a good enough plan.
CareSource, for instance, has become such an important provider of services for the state — insuring 840,000 of Ohio’s 2.2 million Medicaid patients — the state is incredibly dependent on it. To borrow a phrase from debate about the Wall Street bailouts, the nonprofit is almost too big to fail. The Ohio Department of Job and Family Services needs it too much.
If the allegations made by the Department of Justice and others are correct, might the sheer importance of CareSource explain how the state audits missed CareSource’s failings?
At the end of the day, government is so big, there aren’t enough auditors in the world to keep up with all the ways that it can potentially be bilked. Ohioans ought to want a law that encourages knowledgeable people who suspect wrongdoing to run to authorities.
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