“The last question is why was this allowed to happen?”
Representative Brandon Gill, chairman of the Task Force on Defending Constitutional Rights and Exposing Institutional Abuses, delivered opening remarks on Wednesday during a fraud hearing where he highlighted the widespread fraud within Medicaid waiver programs, particularly among the Somali community.
At the hearing titled “Universal Basic Fraud: Vulnerabilities in Medicaid Waiver Programs,” Gill cited recent reporting on alleged abuses of Medicaid-funded programs in Ohio, claiming that fraudulent billing schemes have resulted in an estimated $1.2 billion in taxpayer losses in the state alone.
“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,” Gill said. “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,” he explained. “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.”
According to Gill, schemes often involve the fraudster identifying an elderly person, often a family member, who qualifies for federally funded home healthcare services. They then obtain medical documentation supporting their eligibility and use home health businesses to facilitate Medicaid reimbursements. The business then facilitates the payments from the taxpayer to the fraudster while “taking a cut off the top.”
Gill revealed that an estimated $1.2 billion in Ohio alone has been lost due to Medicaid fraud. He also noted that many fraudsters are part of immigrant communities in the state.
“Well, just like in Minnesota, many of them are Somali. There are an estimated 60,000 Somalis living in Ohio right now,” Gill revealed. “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.”
He also pointed to investigative reporting that uncovered the fact that many of these businesses operate out of abandoned or windowless buildings, have the same address and corporate names, don’t advertise, charge the same rates, and don’t offer clear details about how they obtained a large number of patients.
“The last question is why was this allowed to happen?” Gill asked. “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."
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