Shocking new reporting from The Daily Wire’s Luke Rosiak has blown the lid off yet another massive fraud scandal, this time surrounding Medicaid payments in Ohio. Rosiak’s reporting adds to the wave of revelations from Minnesota, California, and other states, highlighting how fraud has become a multi-billion-dollar industry – particularly among recent immigrants – as government officials either look the other way or are too incompetent to notice.
The first two installations of Rosiak’s lengthy report were released on Monday and Tuesday, with more expected in the coming days. They detail apparently obvious instances of individuals stealing hundreds of thousands or even millions of taxpayer dollars, living lavish lifestyles while ostensibly “caring for loved ones” in order to receive a government paycheck.
At the center of Rosiak’s investigation is a little-known but rapidly expanding corner of Medicaid spending: so-called “personal services” payments, where individuals are paid to provide low-skill care – often to their own relatives. What he uncovered, after combing through federal data just released thanks to the Department of Government Efficiency, was staggering.
“For decades, the payouts have been shrouded in secrecy,” Rosiak reports, calling the program “a black box.” Now that the data is public, he describes it as “the most blatant waste of federal dollars that I have encountered in my two decades as an investigative reporter.”
In Ohio alone, Medicaid spent roughly $1 billion on home health care services in 2024. But these services often involve little more than “homemaking” tasks like cleaning or cooking. In some cases, recipients simply list “companionship & conversation” as justification for receiving Medicaid funds. Because the work occurs inside private homes, there is virtually no way to verify whether services are actually performed. As Rosiak puts it, the system amounts to “an infinite number of small black boxes inside a black box.”
Entire sections of Columbus, particularly along corridors like Cleveland Avenue and East Dublin Granville Road, have become saturated with home health companies – many of which appear to exist only on paper. One building alone was listed as housing 94 Medicaid-billing companies. It generated an eye-popping $66 million in claims.
Across seven buildings owned by one real estate firm, 288 such businesses billed taxpayers more than a quarter of a billion dollars between 2018 and 2024.
What makes the scheme especially troubling is how easy the system is to exploit. According to one operator, “employees and patients come as a package,” with about 70 percent of workers being paid to care for their own family members.
The arrangement is straightforward. First, someone is designated as a caregiver of an allegedly sick or elderly loved one. Then, a doctor signs off on basic assistance, which means that Medicaid pays that person to provide in-home care. Finally, a middleman company – which are the focus of Rosiak’s investigation – processes Medicaid payments.
“We’re taking a small cut because [Medicaid] pay us and we pay them their hours,” one operator explained. But even if the cut is “small” (and that notion itself seems dubious) multiplied over hundreds or even thousands of patients – most of which may not even be real – that “small cut” adds up.
This structure has enabled individuals with little to no healthcare experience – and in some cases, troubling criminal or financial histories – to generate massive incomes.
Rosiak highlights numerous examples, including a janitorial business rebranded as a healthcare provider billing nearly $100,000 in its first month; companies with no websites or visible operations suddenly handling hundreds of clients; and operators with unpaid taxes or prior fraud convictions running multi-million-dollar Medicaid enterprises.
The physical locations of many of these businesses raise even more red flags. Rosiak describes office complexes allegedly full of home health companies billing Medicaid that are “largely abandoned,” with “piles of mail outside,” “smoke detectors chirp[ing] for new batteries,” and doors bearing signs claiming employees are “on break.” In one case, a company’s office didn’t even have a doorknob.
Despite these glaring irregularities, oversight appears minimal to nonexistent. Audits occasionally identify inconsistencies – such as companies billing for in-home visits while patients were simultaneously hospitalized – but consequences are negligible. One firm was asked to repay just $1,000 despite millions in questionable claims. In another case, more than half of payments didn’t match electronic records, yet no repayment was required after the company said its “employees are confused.”
Even more astonishing is the speed at which some of these companies scale. Unlike legitimate businesses that take time to build clientele, many Medicaid providers appear to start with full rosters almost immediately. Billing patterns show sudden spikes from a handful of claims to thousands within a single month, with revenues jumping from tens of thousands to hundreds of thousands almost overnight.
Underlying all of this is a structural flaw in the Medicaid program itself. Unlike other welfare programs, these services have no strict spending cap and are largely driven by physician recommendations. As Rosiak notes, “It only takes one doctor who will say yes to churn out enough forms to bankrupt a state.”
The implications extend far beyond Ohio. This reporting suggests that Medicaid fraud is not an isolated issue, but part of a broader systemic failure – one that has allowed billions in taxpayer dollars to flow into loosely regulated, easily manipulated programs.
That raises a deeper and more politically explosive question. How is it that two investigative journalists (Parker Thayer of the Capital Research Center is also credited in Rosiak’s reporting) could uncover such obvious abuses simply by visiting locations, reviewing public records, and knocking on doors, while state and local officials remained oblivious?
In one instance, Thayer found official correspondence sitting unopened for five months on the doorstep of one of the companies. In other cases, Rosiak encountered empty offices, contradictory records, and individuals unable or unwilling to explain how millions of dollars were spent.
This is what transforms the story from a case of fraud into a full-blown scandal. The issue is not just that bad actors exploited the system. It’s that the system appears to have no meaningful safeguards at all. When individuals with criminal records who don’t appear to be particularly intelligent can still rip off taxpayers to the tune of millions of dollars, the story is about the public officials who let it happen as much as the fraudsters themselves.
As the Trump administration signals a renewed focus on Medicaid fraud, including a federal task force led by senior officials, this issue is poised to become a major political flashpoint. While it has clear national implications, the real pressure may fall on state governments like Ohio’s, where these programs are administered.
Voters would be justified in asking this simple question: if journalists could see this so clearly, why couldn’t the people in charge – and what are the people asking for their vote going to do about it?
Shane Harris is the Editor-in-Chief of AMAC Newsline. You can follow him on X @shaneharris513.
