Medicaid fraud crackdowns are making the care shortage worse
MASSACHUSETTS, UNITED STATES — Ohio’s governor placed a six-month moratorium on new Medicaid home care providers following a Daily Wire investigation alleging hundreds of millions in fraudulent billing by home health agencies in 2024.
According to a report from STAT News, for the state’s disabled residents who depend on those providers to stay out of institutions, the crackdown has created a crisis of its own.
Ohio moratorium cuts home care access
Ohio House Bill 795, known as the SHIELD Act, proposed sweeping anti-fraud measures after legislators cited up to $6 to $8 billion in suspected Medicaid fraud. The bill reached the House Medicaid Committee in June 2026, drawing more than two hours of testimony.
“We will not be moving forward with business as usual when we have up to $6-8 billion of fraud in our system,” said Rep. Jennifer Gross, R-West Chester, chair of the House Medicaid Committee.
HB 795 included mandatory electronic visit verification, GPS tracking requirements for home care providers, new provider restrictions, and a proposal — later stripped from the bill — to ban Medicaid payments to family members serving as caregivers.
The crackdown is landing in an already depleted labor market. Home care workers earn a national median wage of $16.78 per hour, and the direct-care workforce shortage is documented nationwide. A six-month freeze on new home care providers compounds both pressures simultaneously.
Disabled Ohioans fear return to institutions
Jennifer Kucera, chair of the Ohio Olmstead Task Force and a person with spinal muscular atrophy, warned that the moratorium could leave disabled individuals with nowhere to turn.
She previously spent time in a nursing home three blocks from her current home — an experience she described as involving abuse and neglect.
“I’m fine with safeguarding the taxpayer,” said Justin Martin, a teacher with cerebral palsy who relies on Medicaid home care. “I just think we should start with the taxpayers who can’t shower and dress themselves.”
The proposal to ban family caregiver payments was ultimately removed from HB 795 after testimony from disabled Ohioans prompted Republican lawmakers to reconsider — but the moratorium and new compliance burdens remain in place.
CMS Administrator Mehmet Oz has launched fraud investigations in multiple states, making Ohio one front in a broader federal and state effort to audit Medicaid home care spending.
Healthcare outsourcing teams — including those handling Medicaid eligibility verification, claims integrity, provider enrollment, and care coordination — are positioned directly in the compliance layer that fraud crackdowns are targeting.
As states layer new documentation and verification requirements onto home care programs, administrative infrastructure becomes a determinant of whether providers can remain operational.
For disabled Americans, the capacity of that infrastructure is not an efficiency question. It is a question of where they live.
