The Medicaid program in Ohio, which relies heavily on both state and federal funding, is under examination by state auditors for suspicious patterns in home health care spending that might indicate widespread fraud.
Data from the state audit shows that Ohio spent around $1.6 billion on home health services during the review period. Notably, Franklin County accounted for a striking 38 percent of this expenditure, despite making up only about 11.5 percent of the state’s population.
Within Franklin County, a staggering 40 percent of home health spending — roughly $240 million — was concentrated in just two ZIP codes, 43229 and 43231, situated within a short distance of each other in the Columbus area.
The auditors uncovered 288 Medicaid-registered home health companies operating from just seven office buildings along East Dublin-Granville Road. Some of these properties were described as mostly vacant, yet the companies billed for services like companionship and homemaking, which are particularly challenging to validate.
The clustering of these companies in specific areas and the nature of the billed services raised significant concerns regarding the integrity of the program, though auditors emphasized that the investigation is still in the early stages and no definite conclusions have been made.
In a separate report, the 2025 State of Ohio Single Audit, released in late March, evaluated eligibility determinations related to Medicaid services. It found an alarming error rate of 15.6 percent in sampled transactions, including payments made for services to individuals who had passed away.
Auditor of State Keith Faber discussed the potential ramifications of these findings while testifying before state lawmakers. He noted, “If you could and you did literally extrapolate, a 15.6% … error rate could represent as much as $4.4 billion.”
Faber continued, “If the same situation applied to all residents receiving Medicaid services, it indicates potential unallowable costs between $800 million and $4.4 billion.” He criticized the ongoing issues within the Medicaid system, stating that “$1 of loss to an ineligible beneficiary is a loss that Ohioans shouldn’t pay.”
The Auditor’s Office has conducted various compliance audits of individual Medicaid providers in recent years. For instance, an April 2025 review of Mercy Home Health Services LLC in Reynoldsburg (Franklin County) uncovered $661,717 in improper payments over a two-year span and recommended a repayment of $760,295 with interest. Similar audits have successfully recovered millions in questioned costs.
In total, federal and state spending on the Medicaid program surpassed $39 billion in fiscal year 2024, highlighting the scale of the investigation, which remains ongoing.
