Ohio Built a $146,000,000 Medicaid Fraud Detector. Then It Quietly Turned Off the GPS.

Ohio spent $146,000,000of taxpayer money standing up a system whose entire purpose was to stop home-care Medicaid fraud: Electronic Visit Verification, or EVV, which uses GPS to confirm that a paid caregiver actually showed up at a patient’s home before the state cuts a check. It is the single most effective tool the program has against the oldest scam in home health — billing for visits that never happened.

Then, under Governor Mike DeWine (R), the state made the GPS optional. Effective July 1, 2024, the location-tracking function inside the EVV app can be switched on only with the signed consent of the person receiving care — consent that lasts one year and can be revoked at any time. The watchdog the state paid nine figures to build now barks only when the person being watched agrees to be watched.

The result, according to the Ohio Auditor of State, is a hole big enough to drive an industry through. More than half of Ohio’s Medicaid home-care services skipped the required verification entirely — roughly $1,100,000,000in claims with no electronic proof that anyone ever walked through the door. This is not a Democratic scandal: Ohio’s governor, auditor, and attorney general are all Republicans, and it is fellow Republicans who are now sounding the alarm.

• $1,100,000,000 — in Ohio Medicaid home-care claims that skipped the required Electronic Visit Verification controls — 56% of all such services · Source: Ohio Auditor of State
• $825M–$4.4B — in unsupported Ohio Medicaid claims flagged in the FY2025 statewide single audit, at a 15.6% error rate · Source: Ohio Auditor of State, State Single Audit
• $37.39 billion — CMS estimate of improper Medicaid payments nationally in FY2025 (6.12%) — the federal-state program Ohio's loophole feeds into · Source: CMS FY2025 Improper Payments Fact Sheet

Electronic Visit Verification was supposed to be Ohio’s answer to phantom care. Federal law has required states to use EVV for Medicaid personal-care and home-health services for years, and Ohio invested roughly $146,000,000to deploy it. The system logs the time, the location, and the identity of the caregiver at the point of service — an electronic alibi that a visit actually occurred. Without it, the state is taking the provider’s word for it.

The loophole is narrow on paper and enormous in effect. Rather than mandate GPS verification, Ohio rules adopted in 2024 made the location function contingent on the recipient’s written consent — one year at a time, revocable on demand. A caregiver who would rather not be tracked simply needs the patient, who may be a relative, to decline. As Ohio’s current Medicaid director, Scott Partika, conceded to lawmakers, EVV is “absolutely not a silver bullet” — but the state took even that imperfect tool and made it opt-in.

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The numbers come from the Ohio Auditor of State, Keith Faber (R), whose office has been documenting Medicaid leakage for years. In a November 2024 audit, his office found that 56% of Medicaid home-care services were never processed through the required EVV controls — affecting roughly $1,100,000,000 in claims. The state had paid for a verification system and then waved through more than a billion dollars of services it could not verify.

That is one finding among many. Faber’s FY2025 statewide single audit flagged between $825 million and $4,400,000,000 in unsupported Medicaid claims, at an error rate of 15.6%. Separate “public interest” audits since 2019 have identified nearly $1,900,000,000 in improper payments overall — including $118,500,000 in capitation payments made for people who were incarcerated, deceased, or enrolled twice, and about $209,000,000spent on residents simultaneously enrolled in Ohio Medicaid and another state’s program.

“Medicaid fraud is not just a Washington problem. It is happening in our own backyard, with our own tax dollars.”

Keith Faber (R), Ohio Auditor of State · Fox News op-ed

The loophole sits atop a spending surge. Ohio’s Medicaid program paid out roughly $1,000,000,000 in 2024 for home-health services — care delivered inside private residences, often by workers with no clinical training and, in many cases, by relatives of the recipient. A Daily Wire investigation that helped trigger the current reckoning reported finding 288 home-health companies registered at identical addresses, some of them vacant buildings with piled-up mail and “out to lunch” signs. State lawmakers now estimate fraud in the home- and community-based waiver program could exceed $1,200,000,000.

RealClearInvestigations placed Ohio inside a national pattern: home-based Medicaid spending nearly doubled between 2019 and 2024, to $46,400,000,000a year, with much of the expansion flowing through waivers that, RCI reported, grew far beyond what Congress ever explicitly approved. Because the services happen behind closed doors, the investigation noted, “there is no way to know whether the workers went at all, or what they’re actually doing in exchange for taxpayer funds” — which is precisely the gap EVV was meant to close before Ohio made it optional.

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Accountability here runs through a Republican state government, and the site says so plainly. The Ohio Department of Medicaid answers to the governor; the rules that made EVV’s GPS optional took effect on this administration’s watch; and the officials now scrambling to tighten the system are the same ones who oversaw it as the home-care boom accelerated. The political geography of this failure is a fact, and the fact is that it is GOP-governed.

Medicaid is a joint federal-state program: Washington matches state spending, so a dollar lost in Columbus is partly a dollar lost from the federal Treasury. Nationally, CMS estimated $37,390,000,000in improper Medicaid payments in FY2025 — a 6.12% rate, up from 5.09% the year before — with the bulk of the errors tied to insufficient documentation and eligibility problems, exactly the categories EVV and enrollment checks are designed to catch.

Fairness requires a caveat: CMS’s “improper payment” rate measures missing paperwork, not proven theft, and many improper payments are eventually documented and resolved. But the EVV gap is different in kind — it is not a documentation lag, it is a deliberate policy choice to make the documentation optional. That distinction is why a House Oversight task force convened a June 2026 hearing on “rampant fraud” in the Medicaid waiver program, and why federal officials — including CMS Administrator Dr. Mehmet Oz, FBI Director Kash Patel, and Acting Attorney General Todd Blanche — held a news conference in central Ohio announcing indictments.

The political fallout has been bipartisan in its targets and Republican in its cast. Gubernatorial candidate Vivek Ramaswamy (R) has vowed to “crush” the fraud — pointedly noting it happened under GOP leadership — and floated asking Washington to let Ohio keep 65 cents of every fraud dollar it recovers instead of 35, a swing he values at roughly $3,100,000,000. State Rep. Mike Dovilla (R) introduced the Ohio Medicaid Program Integrity and Fraud Prevention Act, which would mandate GPS-tracked EVV, in-person inspections before enrollment, three-year provider revalidation, and fingerprinting for high-risk providers.

DeWine’s administration has suspended dozens of central-Ohio providers, moved to pause new enrollments, and announced fresh oversight — steps critics call overdue. The lesson is the one accountability journalism keeps relearning: a fraud control that the regulated party can switch off is not a control at all. Ohio paid $146,000,000 for a watchdog and then handed the leash to the people it was supposed to watch.

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Last updated June 7, 2026