EXCLUSIVE: Calls Come for Fraud Investigations Into Ohio Day Cares

Medicaid

Last Post by Abigail Nobel 2 months ago

3 Posts

2 Users

1 Reactions

143 Views

RSS

Abigail Nobel

(@mhf)

Member Admin

Joined: 4 years ago

Posts: 1181

Topic starter January 2, 2026 9:41 pm

Medicaid reference emphasized in bold by me.

https://www.dailysignal.com/2025/12/30/exclusive-calls-come-for-fraud-investigations-into-ohio-daycares/

EXCLUSIVE: Calls Come for Fraud Investigations Into Ohio Day Cares

Rebecca Downs | December 30, 2025

FIRST ON THE DAILY SIGNAL—Suspicion of fraud in Minnesota appears to be just the tip of the iceberg. With fraud suspected in Ohio as well, state legislators are on the move. State Rep. Josh Williams, a Republican, is calling for immediate investigations into day care centers, specifically in the Columbus area.

On Tuesday, Williams sent a letter signed by dozens of other lawmakers to the Ohio Department of Children and Youth. The legislators are calling for “unannounced inspections” of daycare facilities that may be suspected of fraud in the Columbus area.

The letter, shared with The Daily Signal, emphasizes the “unannounced” nature, with such inspections described as “an essential tool to identify violations, deter fraudulent practices, and reinforce confidence in the oversight of publicly funded programs.”

“There have been widespread public reports alleging that certain childcare facilities participating in publicly funded childcare programs are fraudulently billing the State of Ohio for children who are not actually in attendance. These allegations raise serious concerns regarding program integrity, the responsible use of taxpayer dollars, and the overall credibility of Ohio’s publicly funded childcare system,” the letter shares.

The lawmakers speak of a further step as well.

“Taxpayer dollars must be protected, and entities found abusing publicly funded programs must be swiftly held accountable. Continuing to direct state funding to facilities suspected of fraudulent conduct is unacceptable, and the Ohio House of Representatives will act accordingly based on the findings and seriousness of this investigation,” the letter reads.

Williams also spoke to The Daily Signal about his aim in sending out such a letter, which is to get the executive branch to further use its authority. “It’s the legislative branch trying to put the onus on the executive branch to do your job and enforce the laws and regulations, which we think is lacking currently,” he said.

Getting to the bottom of such fraud, Williams stressed, requires “robust efforts” when looking into “suspicious” childcare facilities, with a focus on metropolitan areas. Better screening processes are also key.

Concern exists in Ohio because, as Williams put it, the state “is prime for fraud,” especially as it applies to Medicaid. The state representative spoke specifically of expanded programs involving in-house family members acting as aides.

Williams also wished to discuss a bigger picture, including as it applies to the Department of Government Efficiency.

The Ohio version of DOGE, he explained, is the state auditor, though the auditor cannot proactively probe for fraud, and has to do it in response to a call for action. This, Williams explained, is where “Ohio is lacking a little bit.”

DOGE’s aim to go after fraud, waste, and abuse at the state and federal level earned praise from Williams, who specifically cited President Donald Trump and called for such efforts at the state level. He also called out state Democrats who promote funding for a variety of “free” resources, including underperforming schools.

“That’s state tax dollars that could be allocated towards some of those programs to shore up the American dream for actual taxpaying Americans,” Williams added.

The state representative promises to continue following the issue, which also involved a discussion about who is alleged to be engaged in such fraud. Concerns abound about Somali communities in Minnesota.

“I don’t like to demonize any particular group of it, okay? But what we’re seeing is average Americans are not engaged in coordinated cross-level, cross-department type of fraud. It is a consolidated community that essentially has a code of silence and are actively participating in this style of fraud,” Williams offered.

“When it’s within a close-knit community that has a code of silence, that has their own cultural ideologies that are different than the American dream, it makes it prime for fraud, waste, and abuse.”

In addition to unannounced visits, lawmakers are also asking for audits into attendance records and billing submissions; to “immediately suspend or withhold any further state payments” to facilities “where inspections or audits indicate probable fraud”; refer cases to prosecuting authorities; provide the General Assembly with a summary of findings; and continued cooperation with the Ohio Department of Jobs and Family Services’ inspection programs and assets.

ReplyQuote

Topic Tags

10x25mm

(@10x25mm)

Famed Member

Joined: 3 years ago

Posts: 1398

January 3, 2026 8:49 am

On Deck: California !

https://justthenews.com/accountability/waste-fraud-and-abuse/california-could-be-next-step-federal-fraud-probe-after

California likely next step in federal fraud probes after newest revelations in benefit programs
Fake student applications, Medicaid for illegal immigrants, and profligate food programs could make California the next target for federal scrutiny over allegations of benefit fraud.
By Steven Richards - January 2, 2026

From fake student applications seeking aid to unapproved Medicaid benefits for illegal immigrants, California is shaping up to be the next battleground for entitlement fraud after mushrooming Minnesota scandals reminded Americans how much of their tax dollars get misused. Even Democrats like California's Rep. Ro Khanna are concerned the Golden State may have provided a golden opportunity for fraudsters.

President Donald Trump says the confirmed and alleged fraud in Minnesota, which was targeted at the state’s food assistance program, daycare facilities, and medical programs is small “peanuts” compared to the fraud in other states.

“California is worse, Illinois is worse and, sadly, New York is worse — a lot of other places,” Trump said during a New Year’s Eve event. “So, we’re going to get to the bottom of this.”

Tackling state-level fraud a bi-partisan matter

The suggestion that there is fraud in California’s social programs seems to have drawn bipartisan agreement. Khanna, who represents the Silicon Valley in the San Francisco Bay Area, has embraced efforts to tackle state-level fraud to build support for a new wealth tax and ensure its revenues are not wasted.

“If you want, as I do, to advocate for Medicare for all, to advocate for higher taxes, you have to have the public trust,” Khanna said in an interview with CNBC. “People need to have a receipt for what their money is going toward. You can’t have corruption in the government and waste in the government and then expect people to support the progressive ideals that I have.”

Khanna’s proposal, which he said would involve a bipartisan partnership with the House Oversight Committee to investigate state-level fraud, came after a recent report from the California State Auditor earlier this month which designated the state’s Department of Social Services a “high risk” to the financial health of the state as a result of its elevated nutrition assistance program’s high payment error rate.

The problem, according to the auditor, is the state’s CalFresh program, which administers federal Supplemental Nutrition Assistance Program (SNAP) funds. Due to changes in the One Big Beautiful Bill that President Donald Trump signed into law earlier this year, the federal government is no longer guaranteed to cover the whole cost of state programs.

States on the hook for excessive payments made in error

Instead, if states have a payment error rate above a certain threshold, the state is required to contribute anywhere from 5% to 15% of the total program cost with its own funding source. The payment error rate is the rate of over or underpayments of benefits. While California’s payment error rate of about 10% is in line with the national average, it lies above the 6% threshold imposed by the OBBB.

“Because the recent federal changes to SNAP will require California to shoulder part of the cost of the program’s benefits, CalFresh is now a high‑risk program. If the State does not decrease its [payment error rate], it will likely need to spend about $2 billion annually to maintain CalFresh benefits,” the state auditor warned.

“This is particularly concerning considering that California faces growing multiyear budget deficits, as well as a $20 billion operating deficit for SFY 2026–27. The addition of these significant, new state costs will jeopardize a key program for Californians in need and pose a serious impediment to balancing the State’s budget,” the report concluded.

Some states resisting cooperation to fight fraud

The Trump administration believes there is “massive fraud” within the SNAP and other federal benefits programs. Earlier this year, Agricultural Secretary Brooke Rollins requested that states turn over SNAP program data, but a coalition of states sued the administration to block access. California, the state with the greatest number of SNAP recipients at 5.3 million, led the lawsuit. In the data turned over by cooperating states, Rollins said the administration had already uncovered fraud.

One avenue of potential fraud is the growing number of apparent liquor stores and smoke shops that are approved as retailers under the program, which was designed to improve Americans’ nutrition during the Great Depression. According to the Foundation for Government Accountability, which shared the data with Just the News, nearly half of all the liquor and smoke shops it identified in the USDA database were located in California.

In addition to its food programs, California’s community college system has been the subject of growing financial aid fraud in recent years. According to the Los Angeles Times, more than 1.2 million fake students applied to community colleges across the state in 2024 alone.

Because every student that applies to the state schools is admitted, and there are more options for remote and hybrid classes since the COVID-19 pandemic, scammers use the fake profiles to cash in on both federal and state financial aid. According to the Times, the scammers–often running multiple student profiles at once–stay enrolled in classes long enough to collect aid for books, housing, food or other needs and use it for other expenses, like vacations and designer items.

Though the California Community Colleges system captures many of the fraudulent student profiles, data from the chancellor’s office show about $8.4 million in federal and $2.7 million in state aid were stolen in 2024, the Times reported.

In June, the Department of Education implemented new identity verification requirements after California Congressman Kevin Kiley sent a letter warning about the fraud in his state. Part of the changes include a new requirement for an applicant to present an unexpired, valid government ID. The department specifically cited the growth in aid fraud at California’s community colleges for its decision.

Inspector General: "California improperly claimed $52.7 million in Federal Medicaid"

Additionally, the federal Health Department has raised concerns about potential fraud in California’s Medicaid system. The Health and Human Services Department Inspector General determined earlier this year that the state improperly claimed $52.7 million in federal Medicaid reimbursement for payments made on behalf of illegal immigrants.

States are generally prohibited from using any federal money to cover care for such individuals and would normally have to pay out of their own state budgets if they provide care to illegal immigrants, the inspector general said in its May report.

“California improperly claimed $52.7 million in Federal Medicaid reimbursement because it continued to use the proxy percentage that was developed in the early 2000s without assessing whether the percentage correctly accounted for the costs of providing nonemergency services to noncitizens with [Unsatisfactory Immigration Status] under managed care. In addition, California did not have any policies and procedures for assessing and periodically reassessing the proxy percentage,” the inspector general wrote.

But this is only a part of the Medicaid story. There are also concerns that California is using a loophole in the law to funnel billions of federal dollars into paying for healthcare for illegal immigrants, according to a report released earlier this year by the Paragon Health Institute and the Economic Policy and Innovation Center.

According to the report, California “taxes Medicaid insurers and then makes higher payments to those same insurers with that tax revenue. The higher payments enable the state to claim additional federal matching dollars.” These surplus funds are then available to the state to use elsewhere, like expanding Medicaid services for illegal immigrants.

"The state of California, colluding with insurance companies who cover Medicaid beneficiaries, has created one of the most outrageous ones yet, a money laundering scheme that results in California obtaining more than $19 billion in federal money without any state contribution over the period from April 2023 through December 2026,” President of EPIC Paul Winfree told Fox News earlier this year.