A whistleblower is alleging that a large-scale Medicaid fraud scheme has operated for more than a decade within parts of Ohio’s Somali community, mirroring the massive social services fraud scandal still unfolding in Minnesota.
According to the whistleblower, the scheme has cost taxpayers millions of dollars and continues due to weak oversight and regulatory loopholes.
“Minnesota was just the beginning”
In an interview with Fox News Digital, Ohio attorney and conservative commentator Mehek Cooke said the Minnesota case exposed only a fraction of a much wider problem.
“Minnesota was just the tip of the spear,” Cooke said.
She claimed that multiple providers within Ohio’s Somali community privately contacted her to report pressure to participate in a coordinated Medicaid fraud operation.
How the alleged scheme works
According to Cooke, the alleged fraud centers on Ohio’s home health care Medicaid waiver program.
The program allows individuals to receive payments for caring for elderly or disabled family members. In some cases, payments can reach up to $91,000 per year per recipient.
However, Cooke alleged that some participants exploit the system by fabricating or exaggerating medical conditions.
She said doctors involved in the scheme allegedly approve claims without proper verification and receive kickbacks in return.
“They’re rubber-stamping these claims,” Cooke said. “Then, days later, the same person who was supposedly bedridden is active on social media. The symptoms simply don’t add up.”
Focus on criminal actors, not communities
Cooke emphasized that she does not blame the broader Somali community.
“The problem is not the community,” she said. “It’s the criminals within the community who have exploited one of the easiest Medicaid systems in the Midwest to game.”
She added that Ohio law allows family members to become paid caregivers, even when no medical necessity exists.
“This loophole was built with compassion,” Cooke said. “Unfortunately, it’s being abused.”
Fear and lack of oversight
Cooke said providers who came forward did so at serious personal risk. According to her, some told her they feared violent retaliation if exposed.
She also blamed the lack of independent oversight.
“There are no consistent random visits,” Cooke said. “There’s no second layer of verification. As a result, people are coached to lie to doctors.”
She claimed that providers estimate up to 99% of recipients receiving the benefit do not qualify.
State investigations underway
Ohio Attorney General Dave Yost confirmed in November that his office was investigating nine Medicaid providers for fraud.
Those providers allegedly stole a combined $530,888 from the program.
Cooke believes the true scale of abuse is far larger.
“What we’re seeing in Minneapolis is just a snippet of what’s happening in Ohio,” she said.
Calls for audits nationwide
Cooke urged Ohio and other states to conduct full audits of their Medicaid waiver programs.
“At the end of the day, Ohio taxpayers are hurting,” she said. “The American people are hurting. We don’t have unlimited tax dollars.”
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