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A billion dollars a year. Hundreds of shell companies. And a program designed to help people stay at home that can be exploited with little more than an NPI number and an LLC. That’s the allegation at the heart of today’s Mojo Minute, sparked by an investigation into Ohio’s Medicaid home health waiver billing and the uncomfortable math hiding in plain sight.

We walk through the reported mechanics of the scheme: “providers” clustered at the same addresses, empty buildings tied to huge Medicaid reimbursements, and family-member caregiving arrangements that can be legitimate yet become a low-effort pathway to fraudulent claims when verification is weak. If you care about healthcare fraud, Medicaid oversight, or how public spending can leak through administrative gaps, the details here are both simple and infuriating.

Then we widen the lens to the policy side. We talk about how Ohio’s Medicaid architecture expanded over time, how oversight can fail to scale with dollars and vendors, and why token penalties invite repeat behavior. Finally, we dig into the media angle: local coverage that highlights a small-dollar crime story versus national reporting that argues the real story is systemic and massive. That contrast raises a question you can’t ignore: who is responsible for telling the full truth when the records are public?

Listen, share this with someone who follows Ohio politics or healthcare policy, and leave a review if you want more investigations like this to reach more people.

Key Points from the Episode:

• how the Medicaid home health waiver works and where the honor system breaks  
• why an NPI number and an LLC can be enough to start billing  
• the shell company pattern including dozens of providers tied to one address  
• what “impossible claims” reveal about weak verification  
• how Medicaid expansion and waiver authority can scale risk without scaling oversight  
• why local coverage framed it as a routine crime story  
• the political and media incentives that may shape what gets reported  
• the question we leave you with about incompetence versus something deliberate  

Be sure to check out our show page at teammojoacademy.com, where we have everything we discussed in this podcast as well as other great resources.