Medicaid Wasn’t Built For Man. Ohio Fraud Proves It.

COLUMBUS — As far as office buildings go, 6161 Busch Boulevard is the kind of place you’d probably want to take a shower after leaving. Its exterior is a patchwork of multicolored brown brick, hiding a few windows interspaced with white blocks. It’s got a few fake plants in the lobby and a hideous modern chandelier. Whoever installed the drab gray carpet seems to have been totally inept at his job; even the rental listings didn’t try to hide the pervasive wrinkles. 

Speaking of renting, the space costs just $11 per square foot (half the average in Columbus). Most likely, the building would be a quiet place from which to run your operations. When Luke Rosiak, an investigative reporter at the Daily Wire, visited the building, the employees at “Vitality Rehab & Wellness” and “Reliable Home Health Care” had tragically just left — or so pieces of paper taped to office exteriors told him. (READ MORE: Keeping Up With the Congresswoman)

I find it a bit hard to get angry at the owners of these healthcare LLCs. Yes, they set up these tiny businesses. Yes, per recently released government data, they’re billing the government for services like “homemaking” and “companionship” to the tune of tens of millions of dollars under the auspices of Medicaid funding. And yes, those dollars are actually coming from our pockets. But really, all things considered, it was simply too easy to game the system.

Per Rosiak’s investigation at the Daily Wire, the owners of these little LLCs tend to be exactly the kind of people you’d expect. They’re usually guilty of “years of unpaid taxes and debts, sometimes criminal records, and an astonishing number of LLCs created in other industries, as if the millions they make from Medicaid are just a side gig.” In a recent article, Rosiak detailed the criminal activities of Mamusu Kanu and her husband, Alieu Conteh, both of whom have criminal records but have still been able to charge taxpayers some $936,000 between May 2021 and October 2024 for services rendered to patients who “just come,” despite a suspicious lack of advertisement. 

These kinds of details should raise all sorts of red flags, and yet, the federal government just shelled out taxpayer dollars anyway. The problem is that the buck doesn’t seem to stop anywhere with Medicaid. (RELATED: Washington’s Fraud Factory)

At first glance, a government health insurance program offered to people who, for some reason, don’t qualify for employer-sponsored health insurance and can’t afford to pay high premiums doesn’t sound like all that bad an idea. It’s nice of the federal government to care, I suppose.

Look a bit closer and, as any Republican will tell you, the system is totally broken.

Despite being a federal program, Medicaid is run by the states. They approve charges knowing that the federal government will match some predetermined percentage of their expenses. Originally, Medicaid could only be applied to select services, but in some states, waivers are granted to expand the coverage. For instance, in Ohio, a waiver allows qualifying individuals to receive “home care,” including the services of a personal “attendant,” “home delivered meals,” and “home modification” should that be necessary to help, say, a wheelchair-bound patient. 

That sounds lovely. It means that Granny can get someone to build a ramp that lets her get into her home a bit more easily, or get a nurse to visit her a few times a week to make sure she’s alright, all on the taxpayer’s dime. In an ideal world, perhaps Granny’s kids would help out, but, unfortunately, we don’t live in an ideal world, and so the taxpayer is pitching in instead.

It should be noted that the federal and state governments aren’t paying Granny, but rather they’re paying the companies she hires to help her out — companies the state Medicaid agencies approved to provide those services.

Enter the fraudster. 

Let’s say you’re tired of being the shift manager at some restaurant or department store, and your 65-year-old mom is at home. So you open an LLC with “Home Health” somewhere in the title and apply to the state to get an NPI number — the identifier necessary to bill Medicaid. You rent an office space for a few hundred dollars a month, and the state Medicaid agency kindly ignores the fact that you have no training, no prior experience, and possibly a criminal record, and gives you the NPI number. Your LLC then bills taxpayers a few hundred thousand dollars a year and pays you, its employee, to cook for your mom and quit your job.

Unfortunately, this hypothetical example is possibly the least problematic one. Technically speaking, our hypothetically dutiful business owner is exploiting the system, but hopefully, he’s at least helping his mom out. Other company owners seem to be serving imaginary individuals. In a particularly egregious example, Rosiak discovered a politician “who founded an $11 million home health care company that he appeared to run part-time — without even mentioning it in his political biography — who funded his campaign with donations from other home health care owners.” (READ MORE: The Spirit of Boss Tweed Returns as Public Spending Spirals)

It’s worth acknowledging the very obvious demographic issue at play here. Columbus is home to the second-largest population of Somalians in the United States, and they keep showing up as owners of LLCs that, at the very least, seem to exhibit some pretty blatant red flags. That said, to argue that the whole thing is just an ethnic or immigrant issue is to give a badly designed political program a free pass. Medicaid’s structure all but invites abuse by anyone who is a smidge entrepreneurial and sufficiently unscrupulous. 

The whole thing is just too easy, and “[s]ince the services are performed inside private residences, there is no way to know whether the workers went at all, or what they’re actually doing in exchange for taxpayer funds.” (RELATED: How Medicaid Made a Billion-Dollar Crime Inevitable)

As should be expected, the issue has already become an election issue. In a recent interview with radio host Bruce Hooley, Ohio State Auditor Keith Faber used the story to try to convince Ohio voters to make him the next attorney general. While prosecuting fraud is great, it may very well turn out that, if attempted, it becomes an endless game of whack-a-mole. The desire to preserve the program is noble, but it fails to take into account the trouble with these kinds of programs to begin with.

This kind of fraud is evidence of a very simple fact: The promise of hundreds of thousands of dollars is just too good for men not to take advantage of a system whose designers failed to account for the fallen nature of their beneficiaries. If men were angels, perhaps we could have nice things. But they aren’t, and we can’t.

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