The proposed bill, known as the Safeguarding Healthcare Integrity through Electronic Location Data (SHIELD) Act, aims to enhance the integrity of the Medicaid program by requiring the Department of Medicaid to establish electronic verification systems for nonemergency medical transportation and in-home personal care services. The bill introduces several new sections (5164.40 to 5164.406) to the Revised Code, defining key terms such as "breadcrumb location data," "electronic verification system," and "GPS-based verification." It mandates the development, procurement, and implementation of these systems to ensure accurate tracking of services provided to Medicaid recipients, including the use of GPS technology to verify provider locations and service delivery times.
Additionally, the bill outlines the requirements for Medicaid providers to utilize these electronic verification systems, detailing the conditions under which claims for services will be paid. It establishes a framework for exemptions from the electronic verification requirements and mandates the development of automated fraud-detection tools. The Department of Medicaid is also tasked with submitting annual reports to the General Assembly on the effectiveness of these systems, including data on claims submitted, fraud cases identified, and overall cost savings to the Medicaid program. The act emphasizes the protection of patient information and ensures that recipients are not denied necessary services due to provider compliance issues.