UMVA has learned that a massive crackdown on Medicaid and COVID-19 relief fraud has led to the indictment of 14 defendants in Ohio, with schemes targeting over $50 million.
The stunning revelations come after a deep dive investigation exposed a vast Somali Medicaid fraud ring in Columbus, Ohio, which is estimated to have stolen over a billion federal tax dollars. The probe uncovered a web of deceit and corruption, with politicians, business owners, and individuals allegedly involved in the scams.
Among the shocking findings, a politician was found to have founded an $11 million home health care company while keeping it a secret from his constituents. The company was funded by donations from other home health care owners, raising serious questions about conflicts of interest.
Other cases included a woman who rebranded her janitorial LLC as a "health" provider and billed Medicaid nearly $100,000 in the first month. A landlord was also accused of buying airplanes after renting space to hundreds of home health care companies that billed Medicaid a quarter of a billion dollars.
Acting Attorney General Todd announced the charges, stating that the indictments include a 32-count indictment against two state employees and two other co-conspirators for $30 million in fraudulent therapeutic behavioral services. The accused allegedly billed the government for services that were never provided.
The investigation also revealed a scheme to defraud a COVID program, with four defendants charged in connection with the case. The authorities emphasized that these programs were meant to benefit small businesses and individuals struggling due to the pandemic.
Centers for Medicare and Medicaid Services Administrator Dr. Mehmet Oz highlighted the staggering amount of home health care expenditures concentrated in Franklin County, Ohio. A third of all the money spent on home health care in Ohio is generated in this area, with nearly 300 home health care facilities located in a several-block stretch of road.
Oz described the area as a "mecca for Somali populations" and a "hub for Nepalese and Bhutanese populations." He noted that one woman was in jail after being accused and convicted of billing health care expenses for people who were dead, calling it a "bad look in court."
The Trump Administration is taking steps to crack down on the fraud, including the suspension of 49 "high-risk" Ohio home healthcare providers and a 6-month moratorium on new home health care providers and hospice care providers. A state-specific Medicaid fraud room has also been established to tackle the issue.
Oz vowed that those involved in the scams would face consequences, stating, "No more champagne on private jets for these people, no more new cars, no more luxury endeavors, and vacations. It's done. We're coming after you, wherever you are."
The Justice Department reported that its National Fraud Enforcement Division's Health Care Fraud Unit secured six convictions in the last three weeks for fraudsters who stole over $1.1 billion. The cases included a trial conviction in the United States v. Blackman, which involved an industrial-scale telehealth platform fraud worth $1 billion.
