The United States Department of Justice has announced a significant fraud enforcement push in the state of Ohio, describing it as part of a broader campaign against the theft of taxpayer money from government programs. Officials framed the effort as a partnership between federal authorities and state officials that they hope can serve as a template for similar work in other states.
At the center of the announcement was a thirty two count indictment unsealed against two state employees and two other co conspirators. According to officials, the group is accused of billing the government roughly thirty million dollars for therapeutic behavioral services that were never actually provided, an example the department held up to illustrate the scale of the alleged abuse.
Officials drew particular attention to the concentration of home health operations in one part of the state, saying that hundreds of home health care facilities were clustered along a single road within a few blocks. They noted that some of the buildings involved were vacant, raising questions about how genuine care could have been delivered from those addresses.
As part of the crackdown, the Ohio Medicaid office was set to announce the suspension of forty nine home health care providers that had been identified as high risk to the program. Officials accused those providers of billing millions of dollars while taking advantage of vulnerable people, and warned that such operators would no longer be able to profit from the system.
The state also moved to slow the growth of the sector. Officials said Ohio Governor Mike DeWine had sought a six month moratorium on all new home health care and hospice operations in the state, a request that was granted within a day. They compared the step to placing a bandage on a wound while authorities worked to remove those abusing the Medicaid program.
Officials said much of the focus involved applied behavioral analysis, or ABA therapy, used to treat children with autism, which they described as having been scandalously abused. They reported that nine providers had been paid more than one million dollars each for those services in the past year, with the top provider earning over three million dollars, far above the roughly two hundred thousand dollars an average provider receives.
To strengthen the collaboration, officials announced that federal Medicare and Medicaid agencies and Ohio would launch a state specific Medicaid fraud room modeled on one created at the federal level. They said the state of Indiana had also been asked to work with Oracle Health to build a tool that would give all states comparative information about high risk providers in their areas.
Finally, officials said they had asked all fifty states to revalidate ABA therapy and other high risk provider categories, and that every state had agreed to take part. Each state, they said, was obliged to submit a specific plan by the end of the week, as the department pledged to keep pursuing those involved in high risk schemes across the country.