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Ohio’s Medicaid program, which receives substantial federal funding alongside state dollars, has come under review by state auditors for patterns in home health care expenditures that could indicate the presence of wide scale fraud.

According to state audit data, Ohio expended approximately $1.6 billion on home health care services in the period examined. Franklin County accounted for 38 percent of that total, despite representing roughly 11.5 percent of the state’s population.

Within Franklin County, nearly 40 percent of the home health spending — approximately $240 million — was directed to just two ZIP codes, 43229 and 43231, located within four miles of each other in the Columbus area.

Auditors also identified 288 Medicaid-registered home health companies operating out of seven office buildings along East Dublin-Granville Road. Some of these buildings were described as nearly vacant, with companies billing for services such as companionship and homemaking that are difficult to verify through traditional documentation.

The geographic clustering and service types prompted questions about program integrity, though auditors have stressed that no conclusions have been reached and the investigation is ongoing.

Separately, the 2025 State of Ohio Single Audit, which was released in late March, examined eligibility determinations across Medicaid-funded services. Testing revealed an error rate of 15.6 percent in the sampled transactions, while findings included payments made for services to residents who had died.

Auditor of State Keith Faber addressed the potential scale of the problem while testifying before the state legislature. “If you could and you did literally extrapolate, a 15.6% … error rate could be as much as $4,400,000,000,” he said.

“If the same parameters existed across the entire population of residents receiving Medicaid-funded services, that would mean between $800 million and $4.4 billion in potential unallowable costs,” Faber added in his official single-audit summary. “What we found is a continuing problem in the Medicaid system where the state is not actively cleaning up its books and records,” and “$1 of loss to an ineligible beneficiary is a loss that Ohioans shouldn’t pay.”

The Auditor of State’s Office has conducted multiple compliance examinations of individual Medicaid providers in recent years. For example, an April 2025 review of Mercy Home Health Services LLC in Reynoldsburg (Franklin County) identified $661,717 in improper payments over two years and recommended repayment of $760,295 including interest. Similar examinations of other providers have recovered millions in questioned costs.

Federal and state expenditures on the program exceeded $39 billion in state fiscal year 2024, according to Faber’s office. The investigation remains ongoing as of this report.

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