Ohio House Research

HB 795 Substitute Comparison: What Changed on June 8

What changed between the June 3 and June 8 versions of HB 795 — provisions removed, provisions added, provisions modified — sourced to the LSC comparison document.

Published June 8, 2026

A public records compilation of the changes between the two most recent substitute versions of Ohio HB 795 (the SHIELD Act — Safeguarding Healthcare Integrity through Electronic Location Data), accepted by the House Medicaid Committee on June 3 and June 8, 2026.

On Sunday morning, June 8, one day before the expected committee vote and two days before the Ohio House’s last session day, the House Medicaid Committee accepted a new substitute version of HB 795 (version l_136_3280-5), replacing the version accepted five days earlier on June 3 (version l_136_3280-2).

The changes are documented in an 18-page Substitute Bill Comparative Synopsis prepared by LSC attorney Jason Hoskins. This document summarizes those changes, categorizes them, and flags patterns worth examining.

Every factual claim is sourced to the LSC comparison document or to previously published reporting. The LSC comparison is available at legislature.ohio.gov — Documents.

What was removed from the bill

These provisions appeared in the June 3 substitute but are listed as “No provision” in the June 8 version. All were removed entirely.

Provisions that generated organized public opposition

Family caregiver ban — removed. The June 3 version prohibited a spouse, parent, grandparent, great-grandparent, grandchild, brother, sister, aunt, uncle, niece, nephew, or step-relation from receiving Medicaid payment for providing personal care services to a family member enrolled in a waiver. The June 8 version contains no such provision.

This provision drew the most public opposition. On June 4, disability advocates packed the Medicaid Committee hearing. Justin Martin, a teacher with cerebral palsy who uses a wheelchair, testified: “I’m fine with safeguarding the taxpayer. I just think we should start with the taxpayers who can’t shower and dress themselves.” Jennifer Kucera of the Ohio Olmsted Task Force said: “There will be human damage.”

Family caregiver ban: LSC comparison, p. 1 (R.C. 5166.04(M); conforming change R.C. 5164.41(C))
Martin and Kucera testimony: Statehouse News Bureau, June 4, 2026

SNAP categorical eligibility restrictions — removed (both provisions). The June 3 version prohibited gross income limits for SNAP-eligible households from exceeding federal standards and barred categorical eligibility for households receiving noncash benefits. Both provisions are absent from the June 8 version.

LSC comparison, pp. 2-3 (R.C. 5101.5411(B) and (C))

Whistleblower bounty awards — removed. The June 3 version allowed the Auditor of State to issue awards of up to 10% of fraud recovery amounts to individuals who reported fraud. The June 8 version contains no such provision.

LSC comparison, p. 4 (R.C. 117.103 and 117.104)

Enforcement and penalty provisions

Medicaid Program Integrity Fund — removed. The June 3 version created a dedicated treasury fund to capture all Medicaid fraud recoveries (restitution, civil settlements, forfeitures) and authorized the Attorney General to use it for fraud enforcement, analytics, whistleblower administration, verification oversight, and program integrity operations. The June 8 version contains neither the fund nor the AG authorization.

LSC comparison, p. 2 (R.C. 109.852 and 109.852(B))

200% restitution for Medicaid fraud — removed. The June 3 version permitted courts to require fraud restitution of up to 200% of the value of property, services, or funds obtained, payable to the Integrity Fund. The June 8 version contains no restitution provision.

LSC comparison, p. 4 (R.C. 2913.40(E)(2))

Inspector General designated as “peace officer” — removed. The June 3 version added the Inspector General and Deputy Inspector General to the legal definition of “peace officer” while investigating Medicaid fraud, granting law enforcement authority. The June 8 version contains no such provision.

LSC comparison, p. 4 (R.C. 109.71, 109.77, 121.483, and 2935.01)

Mandatory prison terms at top fraud tiers — removed. Both versions make Medicaid fraud a fifth-degree felony with a $1,000 fine (up from a first-degree misdemeanor). But the June 8 version restructured the penalty tiers, raising dollar thresholds and eliminating mandatory prison at the two highest tiers:

Note: The two versions use different dollar thresholds for the same felony degrees. The table below shows the June 8 dollar ranges with the June 3 thresholds noted in parentheses where they differ.

Fraud amount (June 8 ranges)	June 3 version	June 8 version
$1,000–$7,500	4th degree felony, $5,000 fine (June 3 threshold: $1,000–$5,000)	4th degree felony, $5,000 fine
$7,500–$75,000	3rd degree felony, $25,000 fine (June 3 threshold: $5,000–$25,000)	3rd degree felony, $25,000 fine
$75,000–$150,000	3rd degree felony, prison presumption, $75,000 fine (June 3 threshold: $25,000–$75,000)	3rd degree felony, prison presumption, $75,000 fine
$150,000–$750,000	2nd degree felony, $150,000 fine, mandatory prison if sentenced (June 3 threshold: $75,000–$150,000)	2nd degree felony, $150,000 fine (no mandatory prison)
$750,000+	1st degree felony, $150,000 fine, mandatory prison (June 3 threshold: $150,000+)	1st degree felony, $150,000 fine (no mandatory prison)

LSC comparison, pp. 10-11 (R.C. 2913.40(E) and 2929.01)

Other removed provisions

Hospice care program overhaul — removed. A full package of new hospice requirements (licensing, suspension, staffing, surveys, monitoring, ownership-change moratorium) was removed.

LSC comparison, p. 5 (R.C. 3712.01–3712.21; Section 4)

Medicaid participant audits, improper payments, and conflict-of-interest prohibitions — removed. Provisions requiring independent audits of Medicaid risk contractors, identification of improper payments, corrective action plans, publication of audit results, and prohibition of conflicts of interest for actuarial firms — all removed.

LSC comparison, p. 11 (R.C. 5162.85–5162.89)

Unclaimed funds recovery framework — removed. Four sub-provisions creating a process for the Medicaid Director and Director of Commerce to share data on suspended/terminated providers with unclaimed funds, file claims, and recover amounts — all removed.

LSC comparison, p. 3 (R.C. 5164.54(A), (B), (C))

What was added to the bill

These provisions were not in the June 3 version. All appear for the first time on June 8.

Medicaid provider disclaimer form. Requires the Department of Medicaid to coordinate with the Attorney General to create a disclaimer form providing an “affirmative and explicit explanation of the penalties specified under Ohio law for Medicaid fraud.” Every person or entity enrolling as a Medicaid provider must sign and return this form as a condition of enrollment.

LSC comparison, p. 5 (R.C. 5164.303(A) and 5164.303(B))

Standardized onboarding process. Requires the Department to establish a standardized onboarding process for all providers with a valid provider agreement, including instruction on all relevant state and federal Medicaid laws and requirements for home care and personal care, established by the Department of Medicaid, Department of Developmental Disabilities, and Department of Aging.

LSC comparison, pp. 5-6 (R.C. 5164.304)

Ownership disclosure at 5% threshold. As a condition of entering into or revalidating a provider agreement, requires each person or entity to disclose the identity of every person with at least 5 percent direct or indirect ownership interest. Requires the Department to verify these disclosures against the U.S. HHS Office of Inspector General exclusion list, prior Medicaid sanctions in other states, and prior fraud convictions. Requires data-sharing agreements with Medicaid MCOs for parallel verification.

LSC comparison, p. 6 (R.C. 5164.305(A), (B), (C), (D))

Criminal records check timing changed. Repeals a current law provision that authorized Medicaid providers or waiver agencies to conditionally employ an individual subject to a criminal records check before receiving the check results. Under the new version, the check must be completed before employment begins.

LSC comparison, p. 7 (R.C. 5164.34(H) and 5164.342(G))

Prior authorization with medical necessity criteria, determination deadlines, and appeal rights. Replaces the June 3 version’s rigid standardized time allowances with a new system: providers submit signed, dated requests documenting medical necessity. The Department must decide within 10 business days, provide written reasons for denial, and allow appeals by individuals, providers, and waiver agencies.

Medical necessity is defined across four criteria: (1) appropriate for the individual’s health, welfare, living arrangement, and expected outcomes; (2) appropriate type, amount, duration, scope, and intensity; (3) the most efficient, effective, and lowest cost alternative; (4) protects the individual from substantial harm if not authorized.

LSC comparison, pp. 13-15 (R.C. 5164.13(C), (D), (E), (G), (H))

MCO prepayment review authority — expanded. The June 3 version generally barred MCOs from initiating prepayment review of a provider without Department approval. The June 8 version lets MCOs initiate prepayment review on their own. It adds a requirement for Department or AG approval to place a provider on claims payment suspension, plus provider notice, grievance process, and appeal rights.

LSC comparison, p. 12 (R.C. 5167.23(C)(1), (2), (3))

MCO fraud reporting expanded to include waste and abuse. The June 3 version required MCOs to report fraud or materially inconsistent billing. The June 8 version additionally requires reporting “credible evidence of waste and abuse.” Also requires the Department to refer potential fraud to the Attorney General “in a timely manner.”

LSC comparison, p. 12 (R.C. 5167.18)

Medicaid Director discretion — new denial and scrutiny authority. The Medicaid Director may now: (a) place a provider on heightened scrutiny instead of suspension/termination/exclusion when the action would cause access-to-care problems; (b) deny an application where the applicant is an owner of, or resides with an owner of, a provider whose agreement was terminated or suspended.

LSC comparison, p. 18 (R.C. 5164.33(A)(1)(c) and (d))

What was modified

Electronic verification for transportation — narrowed to GPS. The June 3 version required “one or more systems” for verification. The June 8 version requires “global positioning system coordinates” specifically. The breadcrumb location-tracking requirement was removed.

LSC comparison, p. 7 (R.C. 5164.401(A), 5164.403(A))

Electronic verification for in-home care — uses existing system with five exemptions. The June 3 version required new EVV systems. The June 8 version instead uses the existing electronic visit verification system, exempting five categories: (1) residential services billed on a daily rate, (2) habilitation services, (3) DD transportation services under HCBS waiver, (4) services in ICF/IID intermediate care facilities, and (5) Assisted Living Program services.

LSC comparison, p. 8 (R.C. 5164.42(A)(3) and (B)(3))

Credible allegation of fraud — narrowed and clarified. The June 3 version defined seven specific fraud indicators. The June 8 version narrows the definition and adds two clarifications: (1) a claim overlapping with a hospital stay is not a basis for a credible fraud allegation if services followed an authorized service plan; (2) the Attorney General or Auditor must submit “fraud with evidence” — not merely a “credible allegation” — to trigger payment suspension.

LSC comparison, p. 9 (R.C. 5164.36(A)(1), (B)(3))

Encounter data system and risk matrix — deferred to studies. The June 3 version required the Department to build and maintain both a Medicaid Encounter Data System and a vendor-contracted risk matrix connecting provider records to the National Provider Identifier. The June 8 version requires only reports to the General Assembly by March 31, 2027 on the potential creation of these systems. Implementation is deferred.

LSC comparison, pp. 16-17 (Section 4)

Provider enrollment address threshold raised. The June 3 version required denial/suspension/termination if a provider was co-located at the same address as two other active HCBS providers in a space under 1,000 square feet. The June 8 version raises the threshold to six other providers at the same address.

LSC comparison, p. 13 (R.C. 5164.302(B))

Administrative hearing timeline removed. The June 3 version required that when a provider’s agreement or payment was suspended based on a credible fraud allegation, the Department must provide a hearing and independent administrative review within 10 business days. The June 8 version removes the 10-business-day requirement.

LSC comparison, p. 9 (R.C. 5164.36(D)(2))

Context: Supporter rationale and substitute bill practice

What supporters of HB 795 have said

Medicaid Committee Chair Jennifer Gross (R-West Chester) defended the bill’s urgency: “We will not be moving forward with business as usual when we have up to $6-8 billion of fraud in our system.” (Reported by Statehouse News Bureau, June 4, 2026)

Speaker Huffman identified addressing Medicaid fraud as one of his “four big issues” for the final session days. (Ohio CPA / Hannah News, June 7, 2026)

Auditor Keith Faber testified before the U.S. House Oversight Committee that his office identified “more than $9 billion in unsupported or fraudulent public expenditures” and that testing found “an ineligible rate of 15.6 percent” in Ohio Medicaid programs. (U.S. House Oversight hearing wrap-up, June 5, 2026)

At the federal event on June 4, officials announced 14 people charged in fraud schemes and 49 Medicaid provider suspensions. Dr. Oz stated: “These people have built millions of dollars to take advantage of our most vulnerable.” (WOSU, June 4, 2026)

No public statement explaining the specific reasons for the June 8 revisions has been identified. Statements may have been made at the June 8 hearing itself, which occurred Sunday morning and has not yet been covered in available reporting.

On substitute bills in Ohio legislative practice

Ohio bills routinely undergo significant revisions through substitute versions, including late in the process. Accepting substitutes near a committee vote or floor vote is not unusual. What is less common — though not unprecedented — is stripping the majority of substantive provisions and replacing them with an entirely different set within five days, particularly when the removed provisions were the subject of extensive public testimony and media coverage.

Patterns worth examining

The following observations come from the comparison document. They describe patterns in the public record that have not been examined in published reporting.

1. The provisions that were removed are the ones the public opposed. The provisions that were added were never subject to public testimony.

The family caregiver ban, SNAP restrictions, bounty hunter awards, and mandatory prison terms all drew organized opposition at the June 4 hearing. Every one was removed.

The ownership disclosure requirements, expanded MCO authority, criminal records check changes, and new ODM Director discretion were not in the June 3 version and therefore were never subject to public hearing or testimony. They appeared for the first time on Sunday morning, the day before the expected vote.

Verify: Compare the June 4 hearing testimony (Statehouse News Bureau; Dayton Daily News) with the newly added provisions above. None of the additions were discussed at that hearing because they did not yet exist.

2. The fraud enforcement infrastructure was deferred while the fraud enforcement rhetoric escalated.

The June 3 version required the Department to build a Medicaid Encounter Data System and a risk matrix connecting provider records — the tools that would give Ohio the capacity to detect fraud systematically.

The June 8 version replaced both with reports to the General Assembly due March 31, 2027 (see “What was modified” above). Fraud detection was downgraded from “build it” to “study whether to build it.” No public statement explains the change; the deferral may reflect cost, complexity, or feasibility concerns.

On June 4 — between the two substitutes — federal and state officials held a “war on fraud” event at the Defense Supply Center Columbus. Acting AG Todd Blanche, FBI Director Kash Patel, CMS Administrator Dr. Mehmet Oz, and Speaker Huffman were present. Officials announced 14 people charged and 49 provider suspensions.

The rhetoric escalated between the aggressive version (June 3) and the version that deferred the actual enforcement tools (June 8).

June 4 event: WOSU, June 4, 2026
Data system and risk matrix deferral: LSC comparison, pp. 16-17 (Section 4)

3. The penalty structure was softened on the same timeline that “crush fraud” rhetoric intensified.

The June 8 version raises the dollar thresholds at each felony tier and removes mandatory prison at the two highest. The $150,000-$750,000 tier (second-degree felony) and the $750,000+ tier (first-degree felony) no longer carry mandatory prison sentences. The June 3 version had mandatory prison for both. The $75,000-$150,000 tier carries a “prison presumption” in both versions, which is legally distinct from a mandatory term.

The threshold changes also matter: under the June 3 version, $75,000 in fraud triggered a second-degree felony with mandatory prison. Under the June 8 version, the same amount triggers a third-degree felony with a prison presumption but no mandatory term.

Vivek Ramaswamy told the Statehouse News Bureau on May 19 he would “crush” Medicaid fraud. Huffman told Hannah News on June 7 that Medicaid fraud was one of his “four big issues” for the final session days. The version heading to a vote has lower penalties at several tiers than the version in effect during the June 4 federal “war on fraud” event. Compare the two columns in the penalty table above.

Ramaswamy: Statehouse News Bureau, May 19, 2026
Huffman “four big issues”: Ohio CPA / Hannah News, June 7, 2026
Penalty comparison: LSC comparison, pp. 10-11 (R.C. 2913.40(E) and 2929.01)

4. MCOs gained power that individual providers and families lost.

The June 3 version imposed burdens on providers, families, and the Department. The June 8 version shifted power toward Medicaid managed care organizations (MCOs) — the large insurance companies that manage Medicaid benefits under state contracts: CareSource, Molina Healthcare, UnitedHealthcare, Anthem, and Buckeye Health Plan.

Specifically:

MCOs can now initiate prepayment review of any provider without Department approval (June 3 version prohibited this)
MCOs must now report waste and abuse in addition to fraud (expanded reporting authority)
MCOs receive data-sharing agreements for ownership verification (new access to provider ownership information)

At the same time, the independent audit and conflict-of-interest requirements for “risk contractors” (R.C. 5162.85-5162.89) were removed entirely. Whether MCOs would have qualified as “risk contractors” under the June 3 definition is a legal question; the LSC comparison does not specify which entities the term covers.

The net effect: MCOs gained new investigative and financial leverage over providers (prepayment review, data access, expanded reporting authority) while a set of audit and accountability provisions that could have applied to institutional Medicaid participants was removed.

MCO prepayment review: LSC comparison, p. 12 (R.C. 5167.23(C)(1))
MCO fraud/waste/abuse reporting: LSC comparison, p. 12 (R.C. 5167.18)
MCO data sharing: LSC comparison, p. 6 (R.C. 5164.305(C))
Participant audit removal: LSC comparison, p. 11 (R.C. 5162.85-5162.89)

5. The timeline of the two substitutes and the congressional hearing

The sequence of events across five days:

Date	Event	Source
June 3	Aggressive substitute (l_136_3280-2) accepted by Medicaid Committee. Includes family caregiver ban, bounty hunters, peace officer designations, mandatory prison.	Ohio House Medicaid Committee
June 4	Rep. Dovilla, who announced the June 3 amendments under his own name and received $15,499.69 from Huffman’s candidate campaign committee (one of 17 candidates who received $14,999 or more from Huffman’s committee in the 2024 cycle), testifies before U.S. House Oversight Committee on Ohio Medicaid fraud.	U.S. House Oversight hearing, June 4; Hearing wrap-up, June 5
June 4	Federal “war on fraud” event at Defense Supply Center Columbus. Huffman, Faber, Oz, Blanche, Patel present. DeWine absent.	WOSU, June 4
June 4	Disability advocates testify against HB 795 at the Statehouse.	Statehouse News Bureau, June 4
June 8	New substitute (l_136_3280-5) accepted. Strips family caregiver ban, SNAP restrictions, bounty hunters, mandatory prison, and most enforcement infrastructure. Adds provisions not previously subject to public testimony.	LSC comparison document (on file; legislature.ohio.gov → Documents)

The aggressive version was in effect for the congressional hearing and the federal event. It was replaced before the committee vote. The two versions may have served different purposes — one for political messaging, one for legislative enactment. Or the revisions may reflect genuine legislative deliberation in response to testimony, cost analysis, or feasibility concerns. The public record shows the sequence.

Verify the Dovilla contribution: ohiosos.gov/campaign-finance → search “MATT HUFFMAN FOR OHIO” → Expenditures → 2024 filings → recipient “DOVILLA”

Verify the committee schedule: ohiohouse.gov/committees/medicaid/meetings

Open questions

The comparison document does not answer these questions:

Who requested the June 8 substitute? The LSC drafts bill language at legislators’ request. The comparison document does not identify which legislator(s) requested the new version. Dovilla (who authored the June 3 version)? Committee Chair Jennifer Gross? Huffman? The June 8 hearing record may contain this information.
Was there public testimony on June 8? The hearing was scheduled for Sunday at 2:00 PM. Whether public testimony was accepted on the new provisions — which had not previously been available for review — is not documented in the materials reviewed here.
Who benefits from expanded MCO authority? The new version gives MCOs prepayment review power without Department approval. Which MCOs hold Ohio Medicaid contracts, and do any of their parent companies or PACs appear in the campaign finance records of the legislators who authored or supported the amendments? Verifiable through Ohio SoS filings and the Department of Medicaid’s MCO contract list.
Why were the enforcement tools deferred? The encounter data system and risk matrix were the provisions that would have given the state technical fraud-detection capacity. They were replaced with a reporting requirement due March 2027. What was the stated rationale for the deferral?

How to verify this document

Claim	How to verify
All provision changes	LSC Substitute Bill Comparative Synopsis, available at legislature.ohio.gov → Documents → look for comparison between l_136_3280-2 and l_136_3280-5
June 3 hearing (substitute accepted)	Ohio House Medicaid Committee schedule
June 4 disability testimony	Statehouse News Bureau, June 4, 2026
June 4 federal event	WOSU, June 4, 2026
Dovilla congressional testimony (hearing June 4; wrap-up published June 5)	U.S. House Oversight hearing, June 4; Hearing wrap-up, June 5
Dovilla press release on June 3 version	Ohio House, June 4, 2026
Huffman→Dovilla contribution	ohiosos.gov/campaign-finance → “MATT HUFFMAN FOR OHIO” → Expenditures → 2024 → “DOVILLA”
Huffman “four big issues”	Ohio CPA / Hannah News, June 7, 2026
Ramaswamy “crush fraud”	Statehouse News Bureau, May 19, 2026

Source

Ohio Legislative Service Commission, “Substitute Bill Comparative Synopsis: Sub. H.B. 795, 136th General Assembly, House Medicaid,” comparing l_136_3280-2 (June 3, 2026) to l_136_3280-5 (June 8, 2026). Prepared by Jason Hoskins, Attorney. 18 pages. Reference: SUHB0795-5-136/ts.

Available at legislature.ohio.gov → Documents.

Methodology

Compiled from the LSC Substitute Bill Comparative Synopsis and published news reporting cited throughout. No confidential sources. No leaked documents. The LSC comparison is a public record produced by the nonpartisan Ohio Legislative Service Commission. Every factual claim is independently verifiable through the sources cited above.