A massive Medicaid fraud scheme in Ohio, involving billions of dollars in questionable payments, was exposed through federal data analysis. The investigation revealed that Ohio's Medicaid waivers allowed payments for services like companionship and conversation to family members, rather than medical care, creating a system vulnerable to fraud. The fraud was concentrated in immigrant communities, particularly Somali populations, where government systems struggled to track individuals due to name variations and missing birth dates. The investigation highlighted systemic challenges in Medicaid oversight, including jurisdictional disputes between state and local authorities, and proposed solutions including rescinding state waivers to restore the program to its intended medical care purpose.
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The Ohio Fraud Investigation That Couldn’t Be IgnoredAdded:
[music] >> The Daily Wire exposed a massive fraud scheme this week in Ohio amounting to billions of dollars in Medicaid benefits potentially being scammed, [music] and Vice President J.D. Vance is already taking action. In this episode, we go behind the scenes with the investigator [music] who brought this fraud to light, The Daily Wire's own Luke Rosiak. We'll discuss how he found the fraud and who tried to stop [music] him along the way.
I'm Daily Wire Executive Editor John Bickley with Georgia Howe. This is a weekend edition of Morning Wire.
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Joining us now to talk about his latest investigative series is Daily Wire investigative reporter Luke Rosiak.
Luke, great to have you on. Great to be with you. So, first of all, how did this investigation into fraud, alleged fraud in Ohio, get started? What drew you to Ohio to investigate fraud in the first place? Well, I've been fascinated by Medicaid for many years because people pointed this out when DOJ was in its infancy that they're kind of nibbling around the edges in discretionary funding, but a huge portion of the federal budget is actually locked up in what they call non-discretionary funding, things like Medicaid. And we were led to believe that there's just nothing you can do about that. It just is what it is. The government has always been kind of secretive about what went on in Medicaid. It was just a black box.
Which was a little strange because we're not really interested in prying into people's personal medical information.
We don't want the names of patients, but if we're paying for something, it would be helpful to know what it is. And so, DOJ, as one of its last actions before it kind of left the limelight, they released this database and it was something like 40 GB. It was a huge data set and you kind of had to know computer programming to dive in, but it was a game-changer. I mean, I've never seen anything like it. It was a a fundamental breakthrough in terms of government transparency and it just let you see what companies were billing government millions of dollars for services that are not even like regular doctors offices like extra stuff. And so it got to the heart of a lot of the fraud that we've heard about in places like Minnesota because those are actually all the results of Tim Walls' what they call Medicaid waivers. That's let certain states do things that are well beyond the medical treatment that Medicaid was really designed for. And so the first step in this investigative process was essentially building this massive computer server and doing a lot of programming that would let let me mine through all these records adding up to billions of dollars a year. All right, so the stuff you really love to do mine through these databases. And what drew you specifically to Ohio then? So Ohio immediately emerged as a top spender on these especially suspicious payments because it also has waivers like Minnesota and that actually let people get paid to hang out with their own family and they don't have to be like like medical professionals or anything.
They can literally just provide what the hell call conversation and companionship to their own family members and that's somehow built to this medical program.
In the last year alone it was a billion dollars for for home health care. And this is tremendously easy to defraud and then at the same time it can be hard to prove fraud which is a really toxic combination. And we've heard about in Minnesota how the you know diagnosis of autism went up 100 fold or whatever it was. I mean you see similar things in Ohio where it's really busting their budget. I mean everybody wants these home health care servants that aren't really medical aids. They'll just come hang out in your house maybe cook for you clean for you and it's probably just your own relatives. It's concentrated in the urban cores and specifically in the areas where there is these refugee and immigrant communities.
All right, so that's a key element here.
You're saying that the immigrant communities seem to be the hotbeds.
Yeah, I mean, I just started with the data and it's funny because the left will accuse you of racism or actually what I found is these people that are making millions of dollars off the government will accuse you of racism for asking about the industry because they acknowledge it's all immigrants. But I just started following the money.
Something really troubling has happened to this quadrant of Columbus, which is the capital of Ohio because every industry has just left and been replaced by these firms that basically get paid by the government to do things that for all of history everyone has just done for their own family. Daycares, watching your own kids, and then this home health care, hanging out with your own family members. And you know, the the veterans hall has been bought up by Somalis that were running like 10 Medicaid businesses out of it and they were fraudulent. A church was sold to a daycare that's all Somali, also very suspicious. And these are people that otherwise maybe working and contributing something to society and now they're in part of this parallel economy. And for those of us that you know, are taxpayers and don't really live in these areas, it's easy to think it doesn't exist. But when you just travel to these areas that which are hotspots, I've never seen anything like the scale of it and it's not hidden.
It's all out in the open. The entire economy has been replaced by billing Medicaid for very dubious things. You mentioned Somalis a few times. Obviously that was a major association in Minnesota.
Are you seeing specifically Somalis associated with this fraud in Columbus as well? Yeah, very much so. I mean, I so there's one landlord that owns seven buildings that collectively have um 288 Medicaid companies in them, billing over a quarter billion dollars to Medicaid.
And so you walk in these big office complexes and just picture very long hallways, and there's just door after door after door, and each one is like a little office, and like the first one and when I got off the elevator on one floor was like the Somali education and resource center. And then you go down the hallway and it's just like home health care this, home health care that, home health care something else. And it just goes on and on forever, and all the offices are closed. Something that fraud investigators and policy makers need to be aware of is that, you know, all of our systems are designed for Americans.
We have social security numbers, we have middle names, our last names are the same as our family members. Um, and none of that applies to these people. I mean, some one of the guys who was making like $10 million a year, something like that, his name is Omar Omar, and that's like all we know about him. There's Muhammad Ahmed and Ahmed Muhammad, and these things get all jumbled up in the government computer systems. They don't have birth dates for a lot of these people. If you look them up in public records, it just says January 1st, cuz they may not even know when they were born. And so, it is important, um, I think for policy members to keep that in mind. Our systems are susceptible to fraud by foreign-born people because our systems have a harder time tracking them, not to mention the fact that they also have the ability to do send money abroad in places where we can't track it, and also flee abroad. But, it's just a sort of a parallel world that I think fraud investigators and police and policy makers are totally uncomfortable or don't have the knowledge to navigate, which is in itself just I think an intolerable, um, policy deficit. You mentioned allegations of racism being leveled at people that even ask about the system. What did you personally get blocked by anybody during this investigation? One of the guys like chased me down a hallway saying, "I'm going to tell everybody you're racist."
And we're just saying, "Well, we're just asking about the the government program, and we're just knocking on doors, whatever the dollar amounts are reported in the government database." He says, "You're only knocking at Somali doors.
I'm just going to tell everybody you're racist." And it did kind of seem like a threat. It seemed like a strategy. Like, that's my strategy. Pretty on the nose there.
>> Yeah, and he said, "You got You don't pay my bills. What do I care about journalists?" And, you know, the irony is that we very much do pay the bills of home health care aids. Um other people were very indignant. They didn't feel like they had to justify this this money. I talked to somebody that has like 30 charges in the courts in Ohio.
He basically threatened me, started listing the names of like my family members, which seemed like an implicit threat of some sort. Okay. And he said, "Yeah, you know, I do have a very long criminal record. I was just too dumb. I didn't know what the law law is."
Um so, that's in the best case scenario, they're just saying, "Yeah, I'm just dumb. I don't even know what the law is in America, but they pay me a million dollars." The overall takeaway was he had no fear, probably correctly, that he's There's There's no threat here.
Nobody's going to come and knock, and nobody's going to really be investigating. You just fill out the form, and the government pays you, and there's no real common sense, or nobody's actually visiting these places where you'll see like there's clearly nobody in many of these offices. Is there anyone whose job it is to be tracking this kind of thing, or is there actually not a person assigned to do that? So, I I didn't get the sense that the Ohio Department of Medicaid was super interested in fraud in my limited interactions with them.
Um Ohio Attorney General is very angry.
He testified to the state legislature about how he doesn't really have the power to do things. He can't even do subpoenas because there's basically a turf dispute between bureaucrats, and the local prosecutors want to reserve that power for themselves. But, local prosecutors don't have the technical knowledge about these obscure programs.
I think that there's an inherent problem in the Medicaid program, which is you're playing with other people's money, meaning the program is run primarily by the state, but the money comes mostly from the federal government. So, some of these states kind of look like it look at it like free money coming into their economy. Even if it's mostly wasted, it's not their state money, it's federal money, which is I think a reason to look at getting rid of waivers entirely. The Trump administration has changed some things recently. The DOJ data set was a huge win, as I mentioned, for transparency. And we also have this fraud task force that's ramping up. I think, again though, what I found is strong indications of fraud, but then also indications that they're moving money around and popping things up under new names or new proxies. And so, I think what you see is a game of whack-a-mole that's somewhat futile. So, I think at the end of the day there is very much a solution here that the Trump administration, I believe, has the power to do, which is rescind the waivers for home health care. And that would restore fairness, I think, because we're all paying for Medicaid as federal taxpayers, that some states don't get extra services than others. We return it to just doing real normal medical care, like it was intended to. And just end this home health care business, because it's it's not even worth the time. It's just too much money going out the door with too little in return. It's just the whole thing's got to be killed. Really upsetting that we can't track down uh taxpayer money, like you said, millions, maybe billions in taxpayer money. But that solution that you've offered seems perfectly reasonable. Uh Luke, thanks so much for reporting. Very fascinating stuff, and we appreciate you coming on.
Thanks for having me.
That was Daily Wire [music] investigative reporter Luke Rosiak, and this has been a weekend episode of Morning Wire.
>> [music]
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