Whistleblower Alleges Extensive Fraud in Ohio Somali Community, Claims Minnesota Cases Are “Just the Beginning”

In what appears to be a growing national trend of social services fraud, an Ohio attorney has come forward with allegations that a widespread Medicaid fraud scheme has been operating within Ohio’s Somali community for over a decade, potentially costing taxpayers millions of dollars.

Mehek Cooke, an Ohio attorney and conservative commentator, told Fox News Digital that the recently uncovered massive fraud scandal in Minnesota was “just the tip of the spear” compared to what she claims is happening in Ohio.

According to Cooke, providers within the Ohio Somali community have confidentially disclosed that they’ve been pressured to participate in what she describes as a “massive” Medicaid fraud operation. The scheme allegedly involves doctors “rubber stamping” home health care payments to family members of elderly individuals for fabricated medical conditions.

“They’re just rubberstamping a lot of these. And then that same individual, a week later, that’s supposed to be bedridden, is all over social media, whether they’re out dancing at a party or something like that. So, the symptoms aren’t really adding up at the end of the day,” Cooke explained.

The alleged scheme exploits a loophole in Ohio’s Medicaid program that allows individuals to receive payments for providing care to family members. These payments can total up to $91,000 per year per individual. Doctors who approve these payments allegedly receive kickbacks as part of the arrangement.

Cooke emphasized that the issue isn’t with the Somali community as a whole but rather with “criminals within the Somalian community that have exploited Ohio’s Medicaid program because we have a system right now that’s one of the easiest in the Midwest to game.”

The whistleblower account comes as Minnesota deals with its own extensive fraud case involving social services. Federal prosecutors in Minnesota have charged dozens of individuals in a scheme that allegedly diverted more than $250 million from a federal child nutrition program.

The providers who approached Cooke reportedly did so at significant personal risk. She claims they told her they would be “stoned to death” if their identities were revealed within their community.

According to these sources, the fraud operates through a systematic process where individuals are coached to lie to doctors about medical conditions. Cooke asserts that her sources indicate that “99 percent of the time” individuals receiving home health care Medicaid benefits have been coached and don’t actually qualify for these benefits.

The alleged fraud takes advantage of insufficient oversight in the state’s Medicaid system. “We have entrusted states to look at the funding and to allocate it to build programs, to build rules and regulations. But unfortunately, in states like Ohio, it is being infiltrated and broken down because you don’t actually have independent assessments,” Cooke stated.

She noted that the lack of random verification visits and independent assessments creates opportunities for exploitation. The current system relies heavily on self-reporting and doctor approvals without sufficient verification mechanisms.

Ohio’s Medicaid program, like those in other states, was designed to provide essential care for vulnerable populations, including the elderly and disabled. Home health care benefits allow family members to be compensated for providing care to relatives who cannot care for themselves, a policy intended to help families avoid costly institutional care while keeping loved ones at home.

Cooke called for broader action beyond Ohio. “I think every state, in addition to Ohio, should be asking for audits of their Medicaid system and their programs,” she said. “At the end of the day, Ohio taxpayers are hurting, the American people are hurting, and we don’t have enough tax dollars.”

The allegations come at a time of increased scrutiny on public assistance programs nationwide, with federal authorities stepping up enforcement actions against healthcare fraud. In fiscal year 2023, the Department of Justice recovered over $2.7 billion from fraud and false claims related to healthcare programs.

State officials in Ohio have not yet publicly responded to these specific allegations. However, Medicaid fraud continues to be one of the largest areas of financial waste in government programs across the country, with the federal government estimating improper Medicaid payments at approximately $80 billion annually.