New Fraud Allegations Rock Ohio Home Health Care Medicaid Programs [WATCH]

Attorney Mehek Cooke is calling for state and federal investigations into what she described as widespread fraud within Ohio’s home health care system, alleging that providers are approving unnecessary services so individuals can bill Medicaid for care that may not actually be provided.

Cooke said the issue was brought to her attention by individuals who attempted to report suspected fraud but were ignored.

According to her statement, the problem centers on providers who she said routinely approve paperwork without proper review, allowing home health care services to be billed regardless of whether the patient truly requires them.

“So these individuals tried to report the fraud that was happening in Ohio, and then eventually came to me to say that we’re watching providers rubber stamp paperwork for home health,” Cooke said.

She explained that Ohio is not unique, adding, “there’s many states like this, Pennsylvania and other states too.”

Cooke described how the system works, saying individuals can claim they are caring for an elderly parent and receive Medicaid payments as long as a doctor has approved the arrangement.

“You can go in and you can say, my aging parent needs a home health care, and I want to provide it so the state will, as long as a doctor has approved it, continue to pay you,” she said.

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She said the number of billable hours can range widely. “It could be for 10 hours, 12 hours, up to 24 when it’s critical care,” Cooke said.

She alleged that this allows some individuals to collect substantial income even when care is not needed.

“So you could sit at home without caring for an elderly parent who really doesn’t need it. Make about 75 to $90,000 a year,” she said.

Cooke said the financial incentives grow when multiple family members are added.

“Now you add two parents. That’s 180 now you add your in laws, 250 you continue to add this and you wonder, what are the services being provided?” she said.

According to Cooke, some providers who refused to approve questionable paperwork were bypassed.

“So a lot of providers came and said, fraud is occurring because we said we weren’t going to rubber stamp this paperwork,” she said.

Cooke alleged those seeking approvals then turned to other providers.

“So they went to other providers, their home health care network, saying, we’ll make it worth your while,” she said.

“Well, sounds like a kickback to me.”

Cooke said the situation raises broader questions about oversight within Medicaid, particularly as enrollment and spending have increased.

“So we really need to investigate the Medicaid system and how much it’s increased since the Somalian population came and who really needs critical care,” she said.

She emphasized that critical care services are intended for specific populations.

“That’s meant for our disabled, our elderly, and people who really need it not to just live up our system,” Cooke said.

“And that’s what’s happening in Ohio.”

Cooke said she has alerted authorities to the allegations.

“Authorities are now looking at it from the Attorney General’s office to the US Attorney’s Office,” she said.

“I flagged them all because this is Ohio tax dollars, and we have to take it seriously.”

She rejected arguments that the system cannot be reviewed.

“I’m tired of people telling me, Well, this is the way it’s always been. It’s subjective, and we can’t really check,” Cooke said.

“No, you can audit America. Audit Ohio now.”

Cooke said she plans to continue pressing for audits beyond Ohio. “I’m pushing for that in every single state,” she said.

WATCH:

Attorney Mehek Cooke says massive fraud is taking place in Ohio

She says fraudulent Somalian healthcare companies are being created charging as much as $250,000 per family per year FOR DOING NOTHING, it’s all fraudulent

It’s all being billed to Medicaid and taxpayers are paying… pic.twitter.com/N4PPhqx731

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