Gill Opens Task Force’s First Hearing on Ohio Medicaid Waiver Fraud

WASHINGTON—Task Force on Defending Constitutional Rights and Exposing Institutional Abuses Chairman Brandon Gill (R-Texas) delivered opening remarks at today’s hearing on “Universal Basic Fraud: Vulnerabilities in Medicaid Waiver Programs.” In his opening statement, Task Force Chairman Gill highlighted how fraudsters have manipulated elderly Ohio residents to make fraudulent Medicaid claims. As a result, taxpayers have lost $1.2 billion to foreign fraudsters taking advantage of Ohio’s poorly managed Medicaid waiver system. Task Force Chairman Gill concluded that we must save our society from fraudsters and cheats and protect the availability of critical programs for Americans.

Below are Task Force Chairman Gill’s opening remarks as prepared for delivery:

Good morning, welcome to the first hearing of the Task Force on Defending Constitutional Rights and Exposing Institutional Abuses.

America’s Medicaid system was designed to provide health care for low-income Americans.

Unfortunately, as reporting from Luke Rosiak at the Daily Wire recently revealed, fraudsters and cheats are stealing billions in hard earned American tax dollars.

This is something we’ve seen before. Just a couple months ago, the House Oversight Committee examined a similar problem in Minnesota, where Somali fraudsters stole over $16 billion from American taxpayers.

Today we will be examining Ohio, which appears eerily similar.

Ohio broadened its Medicaid program through Home and Community-Based Services or HCBS waivers authorized under the Social Security Act.

HCBS waivers allow states to provide home based healthcare, as opposed to providing healthcare in hospitals or other institutions.

But these waivers also allow states to cover non-medical personal care services such as cooking and cleaning, as well as “companionship and conversation.”

The problem is that fraudsters are billing Medicaid for personal care services that were never actually provided.

Here’s how it works:

A fraudster finds an elderly person in Ohio – oftentimes a family member – who he believes will qualify for federally funded home health services. The fraudster then gets a note from a doctor which vouches for the elderly person’s supposed needs.

Because the fraudster is unequipped to deal directly with the Medicaid bureaucracy, he contracts with a Home Health business, who acts as an intermediary between himself and the federal government. The business then facilitates Medicaid payments from the taxpayer to the fraudster, while taking a cut off the top.

In the personal care Medicaid waiver program, in Ohio ALONE, taxpayers have lost an estimated $1.2 billion dollars due to fraud. $1.2 billion of hard-earned American tax dollars are in the hands of criminals.

So who are these fraudsters?

Well, just like in Minnesota, many of them are Somali. There are an estimated 60,000 Somalis living in Ohio right now. That means that Ohio has the second largest Somali population in America – second only to Minnesota.

In addition to Somali fraudsters, Ohio is home to the largest population of Bhutanese immigrants in America.

Recent reporting shows that the Somali and Bhutanese communities commit a large portion – if not the vast majority – of home health Medicaid fraud in Ohio. It may not be politically correct to say, but it’s true.

So what do we know about these businesses that are facilitating Medicaid fraud?

Thanks to Rosiak’s investigative reporting, we know quite a bit. They often have names like Capital Home Health, Continental Home Health, Dynamic Home Healthcare or Ohio Senior Home Healthcare – or some derivation of that. Many of them operate out of largely abandoned, often windowless, buildings – like the one at 6161 Busch Boulevard which is home to 94 different companies that have recently billed Medicaid $66 million.

There have also been multiple reports of other abandoned buildings, companies sharing the same address, and corporate names that are identical.

Indeed, many of these companies appear virtually indistinguishable from one another, do not advertise themselves, charge the same rates, and offer no clear explanation of how they even acquired large numbers of patients, often seemingly overnight.

The last question is why was this allowed to happen?

This is another question this hearing will seek to answer. Of course part of the answer immigration. The reality is that America wouldn’t have a problem with Somalis and Bhutanese populations defrauding us if we didn’t import large numbers of Somalis and Bhutanese to begin with. That appears to be the tip of the iceberg of a gross abuse of America’s immigration system.

For too long, our government allowed foreigners from low trust societies with little vetting to pour into our communities.

Now, as elected officials, we cannot stand idle as these fraudsters exploit our welfare system and get rich off American taxpayers. And we cannot back down to fraud simply because of spurious slanders of racism.

Secondly, as we will discuss, we have a problem with verifying the integrity of America’s welfare programs. Programs like the Electronic Visit Verification system – including its GPS tracking system – were not properly utilized. That means that in many cases, we cannot even verify if any of the billed home health services were even provided. In many cases, family members are billing Medicaid for alleged services provided to their own relatives. At the same time, Billboards in Columbus even advertise that people can “[g]et paid” for “[c]aring for a loved one at home.”

The result is that fraudsters and fraudulent home health businesses are stealing massive sums of money by abusing and defrauding federal Medicaid.

This isn’t just about safeguarding our constituents’ hard-earned tax dollars, but it is also about saving our society from fraudsters and cheats and protecting the availability of critical programs for Americans.

According to Centers for Medicare & Medicaid Services Administrator Oz, half of all fraud in federal government programs is in healthcare. He recently revealed that eliminating fraud in Medicare would double the life expectancy of the Medicare trust fund without any other legislative fixes.

The purpose of this hearing is to better understand the nature, scale and scope of Medicaid fraud in Ohio, to understand why it happened and to better understand who is responsible.

I thank our witnesses for appearing today on this important topic.