Ohio’s Medicaid Billing Loophole: $1 Billion a Year, 288 Shell Companies, and the Whistleblower Nobody Listened To
Ohio built a $146,000,000 electronic tracking system to verify that home health aides were actually showing up to care for the elderly and disabled Ohioans whose taxpayer-funded Medicaid benefits paid their wages. Then, in March 2023, state officials quietly made the GPS component of that system optional.
The consequences were immediate and measurable. Ohio’s own auditor found that 55 percent of all Home and Community-Based Services claims filed the year before — totaling $1,100,000,000 out of $2,000,000,000 — carried no GPS verification at all. Investigators at the Daily Wire cross-referenced Ohio Medicaid enrollment records against state business filings and found something that should have triggered alarms in any compliance office: 288 registered home health companies sharing just seven Columbus office buildings, collectively billing $250,000,000 over six years. One building alone housed 94 companies billing $66,000,000.
Whistleblower Mehek Cooke carried evidence of the scheme to Ohio state officials in December 2025. Nobody called back. It took national news coverage in May 2026, a House Oversight letter, a VP directive to the federal Fraud Task Force, and a legislative testimony revealing $9,000,000,000 in total improper payments before state officials acknowledged anything had gone wrong.
- $1.1Bof $2B in 2022 Ohio HCBS claims had zero EVV verification — GPS was made optional by state officials— Ohio State Auditor Keith Faber, 2024
- 288Medicaid-registered home health companies sharing just 7 Columbus office buildings — one building housed 94— Daily Wire / Rosiak
- $250Mbilled by those 288 companies over 2018–2024 — one building alone billed $66 million— Daily Wire / Rosiak
- $9Bin total improper or fraudulent Medicaid spending identified statewide, per Ohio Auditor Faber's May 27, 2026 legislative testimony— WOSU · Auditor Faber
- $146Mspent by Ohio to build the EVV (electronic visit verification) system — then the GPS component was made optional in March 2023— Ohio Auditor EVV Audit, 2024
- Dec. 2025Whistleblower Mehek Cooke first warned Ohio officials — every office ignored her until the story went national in May 2026— Daily Signal
Ohio’s Home and Community-Based Services waivers pay for personal care under billing code T1019 — essentially, paying someone to help a Medicaid recipient with daily living tasks like bathing, dressing, and medication management. The state allows a “self-direction” model in which recipients can designate a family member as their paid aide. On its face, the policy is defensible. In the hands of fraud operators, it is a blueprint.
The scheme, as described in Daily Wire reporting and the Ohio Auditor’s EVV findings, works as follows: Operators register a home health company — sometimes at the same address as dozens of other nominally separate entities. They enroll Medicaid recipients as clients. The clients designate family members as their “aides.” The company then bills T1019 visits at rates that can reach $75,000 to $90,000 per recipient per year. Without GPS confirmation that a caregiver actually traveled to the recipient’s home and stayed for the claimed duration, there is no mechanism to verify that a single visit occurred.
That verification gap was not an accident. Congress mandated electronic visit verification for all personal care Medicaid services by 2020; Ohio spent $146 million building a system that included GPS location confirmation. Then, in approximately March 2023, Ohio Medicaid quietly issued guidance making the GPS component optional — meaning providers could self- certify a visit occurred with no location data required. Ohio AG Dave Yost (R) later told the state legislature that this single policy change made fraud detection “impossible.”
A functioning compliance system would flag 288 Medicaid-enrolled home health companies sharing seven addresses in a single city as a priority audit target. Legitimate home health agencies require physical office space for patient intake, staff scheduling, care coordination, and regulatory compliance. The same address cannot plausibly house 94 separately licensed, separately billing healthcare entities engaged in genuine operations.
Luke Rosiak, Daily Wire: “This is the most blatant waste of federal dollars that I have encountered in my two decades as an investigative reporter.”
Ohio Medicaid Director Scott Partika received a letter from the House Oversight Committee on May 12, 2026 demanding records on how billing anomalies of this scale went undetected for years.
In December 2025, Mehek Cooke — a former Ohio Medicaid compliance professional with firsthand knowledge of the T1019 billing patterns — approached multiple Ohio state offices with documented evidence of the scheme. She met with representatives of the Governor’s office, the Ohio Department of Medicaid, and other state agencies. According to the Daily Signal’s May 20, 2026 reporting, not a single official followed up.
Governor Mike DeWine’s (R-OH) office had been informed in December 2025 and did not respond to Cooke’s warnings. It was not until Luke Rosiak’s investigation ran nationally in April–May 2026 that the Governor issued an executive order directing Ohio Medicaid to address the loophole. DeWine’s office, asked why the December 2025 warning produced no action, has not provided a substantive answer.
“These shocking allegations, if true, show why the Fraud Task Force's work is so important. I'm directing the task force to look into it and take immediate action to prosecute any fraudsters involved and stop all further payments as appropriate.”
VP JD Vance (R) · May 4, 2026, directing the federal Fraud Task Force to investigate Ohio Medicaid billing
On May 4, 2026, VP JD Vance (R) directed the Trump administration’s Fraud Task Force to investigate the Ohio Medicaid billing allegations and take action to stop payments. The directive followed the Daily Wire investigation and a House Oversight Committee inquiry led by Rep. James Comer (R-KY) and Rep. Brandon Gill (R-TX), who is chairing a six-month House Task Force specifically examining HCBS fraud nationwide.
On May 27, 2026, Ohio Auditor Keith Faber (R) testified before the Ohio General Assembly and presented the full scope of what the 2024 EVV audit had found: the $1,100,000,000 in unverified HCBS claims was a subset of $9,000,000,000 in total improper or fraudulent Medicaid spending the Auditor’s office had identified statewide. WOSU covered the testimony and reported that Ohio legislators reacted with proposals for mandatory GPS reinstatement, enhanced pre-enrollment screening, and an independent Medicaid fraud unit with subpoena power.
On May 26, 2026, VP Vance announced at a press conference that the federal Fraud Task Force had identified $164,600,000,000 in fraud findings nationwide — a total that includes but extends far beyond the Ohio Medicaid program. The Ohio case is now a named priority in the Task Force’s published work plan.
These shocking allegations, if true, show why the Fraud Task Force's work is so important. I'm directing the task force to look into it and take immediate action to prosecute any fraudsters involved and stop all further payments as appropriate.
Medicaid data has been open sourced, so the level of fraud is easy to identify.
The Fraud Task Force has now identified $164.6 billion in fraud findings — the direct result of President Trump's directive to expose and prosecute those who steal from American taxpayers. Ohio's Medicaid billing operation is among the active priority investigations. Every dollar stolen from legitimate Medicaid recipients is a dollar that never reached a disabled American who actually needed care.
Paraphrased commentary · not a verbatim post
Governor Mike DeWine (R-OH) — Signed executive order in May 2026 requiring Ohio Medicaid to address EVV loopholes, only after the story went national. His office was warned by whistleblower Mehek Cooke in December 2025 and did not respond.
Scott Partika — Director, Ohio Department of Medicaid. Named in the House Oversight Committee letter dated May 12, 2026. Responsible for the agency that issued the March 2023 guidance making GPS optional despite the $146M system already in place.
Keith Faber (R) — Ohio State Auditor. His 2024 EVV audit is the primary documentary source for the $1.1B unverified figure. Testified to the Ohio General Assembly May 27, 2026, presenting the full $9B improper-payments finding.
Dave Yost (R)— Ohio AG. Warned the legislature that making GPS optional rendered fraud detection “impossible.” The warning was not acted upon.
Rep. James Comer (R-KY) — House Oversight Committee. Co-signed the May 12, 2026 letter to Ohio Medicaid Director Partika.
Rep. Brandon Gill (R-TX) — Chair, House Task Force on HCBS Fraud. Leading the six-month national investigation of which Ohio is the lead case study.
Vivek Ramaswamy — Ohio GOP gubernatorial nominee: “Crushing Medicaid fraud is an absolute top priority.” Ramaswamy has warned publicly that the scale of HCBS fraud could threaten the financial stability of the entire Medicaid program if not prosecuted aggressively.
“This is the most blatant waste of federal dollars that I have encountered in my two decades as an investigative reporter.”
Luke Rosiak · Daily Wire investigative reporter, primary investigator of Ohio Medicaid billing scheme
Ohio spent $146,000,000 building a fraud-prevention system. Then state officials removed the key fraud-prevention component and waited to see what happened. What happened: a whistleblower with documented evidence of the resulting fraud was ignored for five months while the billing continued. The story finally broke nationally only after an independent investigative reporter cross-referenced public records that any Ohio Medicaid compliance officer could have run.
The immediate political beneficiaries of Ohio’s non-response — the officials who made GPS optional, who didn’t return a whistleblower’s calls, who needed a House Oversight letter and a VP directive before scheduling legislative hearings — are Republicans governing a Republican state. That is the documented record. The $9,000,000,000 in identified improper payments is not a partisan talking point. It is the Ohio State Auditor’s sworn testimony.
The Medicaid program is jointly funded by federal and state taxpayers. The federal share of Ohio’s HCBS spending is approximately 60 percent — meaning roughly $660,000,000 of the $1,100,000,000 in unverified 2022 claims was federal money. Congress appropriated that money to provide home care to elderly and disabled Ohioans. A substantial portion of it may have gone instead to companies sharing office building addresses with 93 other Medicaid-registered entities.
