On July 10, 2025, Ohio Attorney General Dave Yost’s office announced that nine Medicaid providers had been indicted for allegedly defrauding the government healthcare program of $1.2 million. The defendants—eight home health aides and one mental health specialist—face varying felony charges of Medicaid fraud and theft for billing for services they did not provide. Two individuals alone are accused of accounting for more than $1 million of the total alleged fraud.
The Medicaid Fraud Control Unit, an arm of Yost’s office, investigated the cases and secured the indictments in Franklin County Common Pleas Court. The unit operates within the Health Care Fraud Section and works with federal, state, and local partners to root out Medicaid fraud and protect vulnerable adults from harm.
Among those indicted:
- A home health aide from Maple Heights, 47, allegedly billed for in-home services while the recipient was hospitalized or incarcerated, resulting in a loss of $4,735 to Medicaid.
- A home healthcare employee from Dayton, 49, allegedly billed for services when a recipient was hospitalized. She admitted to submitting fraudulent claims, causing a loss of $1,888 to Medicaid.
- A mental health specialist from Warrensville Heights, 48, allegedly billed Medicaid more than a dozen times after she stopped providing services to a client. She told investigators she falsified claims to reimburse herself for unpaid work, resulting in a $2,443 loss.
- A home health aide from Cleveland, 28, is accused of claiming reimbursement for 16 hours of services per day for each of six clients, despite never providing that level of care. Two clients said they received no additional services after an initial visit. This caused a Medicaid loss of $724,966.
- A home healthcare employee from Columbus, 39, allegedly billed for in-home services while the recipient was hospitalized on seven occasions. She admitted knowing that billing in these circumstances was illegal, resulting in a loss of $6,523.
- A home healthcare employee from Dayton, 45, allegedly billed for services on 21 days when the recipient was hospitalized. She admitted awareness that billing during hospitalization was prohibited, causing a loss of $1,835.
- A home health aide from Cleveland, 29, allegedly falsified timesheets to make it appear she provided services she did not. She estimated that 80 percent of her claims were fraudulent, stating she submitted them to avoid losing her cash assistance benefits. Medicaid lost $3,385 in this case.
- A caregiver providing care to a relative in Maple Heights, 53, allegedly billed Medicaid for an average of 20 hours of services per day between January 2019 and March 2025. Surveillance footage showed her approaching the recipient’s residence only twice in an 18-day span and never entering the home. Flight records showed she billed Medicaid for 93 days while traveling across several states and the Dominican Republic. This led to a loss of $366,950.
- A home health aide from Cleveland, 54, allegedly billed Medicaid for two shifts when she worked only one for five clients. She confessed to submitting fraudulent claims when confronted, resulting in a loss of $143,731.
Compliance Perspective
Issue
Healthcare providers must ensure that billing for Medicaid services is truthful, accurate, and supported by proper documentation. Submitting claims for services not provided, falsifying timesheets, or billing for care during times when recipients are hospitalized or unavailable constitutes fraud. Such actions risk legal consequences and undermine trust in healthcare programs funded by public resources.
Discussion Points
- Review and update your organization’s policies and procedures to emphasize accurate billing practices, verification of service delivery, and compliance with Medicaid requirements. Policies should clearly define expectations for documentation, billing, and oversight, and be reviewed at least annually.
- Provide comprehensive education and training to all staff involved in care provision and billing processes. Ensure they understand the importance of honest documentation, the prohibition against submitting false claims, and their responsibility to report any suspected fraud, waste, or abuse.
- Conduct regular audits of billing records, timesheets, and service documentation to verify that claims accurately reflect services provided. Audits should detect inconsistencies or irregularities early and be followed by prompt corrective action and staff education to prevent future errors or fraud.
*This news alert has been prepared by Med-Net Concepts, Inc. for informational purposes only and is not intended to provide legal advice.*