Dr. Oz said Columbus, Ohio, has become a major focus in the fight against Medicaid fraud, pointing to a home health care case involving millions of dollars in payments and a broader pattern of questionable billing tied to the state’s home health care system.
Speaking from Columbus, Dr. Oz said the city is home to the second-largest Somali population in the United States after Minneapolis.
He stood outside the former location of La Belle Home Healthcare Company, whose owner, Nizhmi Tassing, was sentenced to three years in jail for Medicaid fraud.
“I’m in Columbus, Ohio, is home to the second largest Somali population in the entire US, after Minneapolis, and I’m standing in front of the La Belle Home Healthcare Company, where it used to be when its owner, Nizhmi Tassing, was recently sentenced to three years in jail for Medicaid fraud,” Dr. Oz said.
Dr. Oz said Ohio Medicaid paid $5.7 million for home health aid services connected to the company.
He said the case involved inflated service hours and billing tied to people who were dead or ineligible for Medicaid.
“Now, Ohio Medicaid paid $5.7 million for home health aid services when the company inflated the hours of services they built for registered nurses. None were present. They built for care of people who are dead or ineligible to receive Medicaid. Now, charging for dead people is a bad look when you go to court,” Dr. Oz said.
Dr. Oz said officials used data mining to identify patterns in the spending.
He pointed to Franklin County as an example, saying the county accounts for more than one-third of Ohio’s $1.5 billion home health care budget.
“We use data mining to identify the sub code again, corruption. I’ll give you an example. Franklin County, where we are now, alone by itself accounts more than a third of the billion and a half dollars spent on home health care in Ohio, that is three times more than what would be expected,” Dr. Oz said.
He said the numbers show how widespread the problem has become in the county.
“The process, that statistic, the corruption is so widespread here that over a third of the entire state’s home health care budget goes to this county, which is three times more than you’d expect,” Dr. Oz said.
Dr. Oz said investigators also identified 288 Medicaid-registered home health aid companies operating from seven office buildings along one nearby road.
He said some of those buildings are nearly vacant.
“We also identified 288 Medicaid registered home health aid companies operating out of just seven office buildings along one nearby road. Some of these buildings are nearly vacant,” Dr. Oz said.
Dr. Oz said home health care and personal care services have been central to recent fraud prosecutions in Ohio, with criminals accused of billing for services that were never provided.
“Home health care and personal care services have become the subject of nearly all of the recent fraud prosecutions in Ohio. Everyone’s upset about criminals billing for services that were never rendered. There were ghost visits, a timeframe,” Dr. Oz said.
He said the Ohio auditor found that almost half of personal care services claims lacked electronic verification, making it unclear whether the services were actually provided.
“The Ohio auditor found that almost half of the personal care services claims had no electronic verification. We don’t really know the business happened. This is fraud at scale,” Dr. Oz said.
Dr. Oz said Gov. Mike DeWine has asked the federal government to approve a statewide six-month Medicaid moratorium on new home health care businesses. He said the request was being allowed within 24 hours.
“As a result, Governor DeWine has asked the federal government to allow a statewide six month Medicaid moratorium on new home health care businesses. Right, we’re allowing that within 24 hours. We’re giving permission, and I’m proud of that, because if we do this the right way, people will stop using Medicaid as a piggy bank,” Dr. Oz said.
Dr. Oz also said Vice President Vance, who is from Ohio, wants the White House Anti-Fraud Task Force to pursue fraudsters nationwide.
“Vice President Vance, who is from Ohio, wants the White House Anti-Fraud Task Force, coming after fraudsters everywhere with everything we have,” Dr. Oz said.
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