Public interest audit identifies 10% of sampled Medicaid recipients could not have citizenship or immigration status confirmed

Ohio Auditor's Office

COLUMBUS — Ohio’s offices that handle applications for Medicaid and other public benefits programs should standardize the documentation and other requirements when determining eligibility, Auditor of State Keith Faber urged in a new audit released Thursday.

The report also identified 10% of sampled Medicaid recipients who could not have their citizenship verified or be confirmed as eligible legal residents. In large public benefit programs, these numbers can lead to significant losses in taxpayer-funded programs, Auditor Faber said.

“I am very concerned that we continue to find that Medicaid misses the mark when confirming eligibility for this vital program,” Auditor Faber said. “Where the other programs we sampled are doing a good job in this area, Medicaid continues to falter.”

This public interest audit determined many of Ohio’s public benefit programs were doing well in determining and confirming eligibility, but Medicaid and Ohio Works First, with error rates of 10% and 3% respectively, were lagging.

The new audit reviewed how state agencies, including the Department of Medicaid and the Department of Job and Family Services, verify applicant citizenship and immigration status during November 2025.

A new federal law, signed in July 2025, includes further restrictions on Medicaid benefits related to citizenship and immigration status. The Ohio Department of Medicaid, effective Oct. 1, likely will have to review about 111,000 beneficiaries of its programming to maintain the new eligibility requirements.

The audit recommended increased requirements for maintaining and sharing data among state agencies that administer public benefits programs.

The policy recommendations are included in an audit in the public interest released Thursday. The full report is available online at ohioauditor.gov/auditsearch/search.aspx

The Auditor of State’s Office, one of five independently elected statewide offices in Ohio, is responsible for auditing more than 5,900 state and local government agencies. Under the direction of Auditor Keith Faber, the office also provides financial services to local governments, investigates and prevents fraud in public agencies, and promotes transparency in government.