Ramaswamy unveils Medicaid fraud plan, wants Ohio to keep more of what it saves 

Vivek Ramaswamy’s plan to fight Medicaid fraud in Ohio includes restructuring how state data is housed and asking the Trump Administration for permission to keep extra money discovered by anti-fraud efforts.

The Republican governor candidate also said that by working with other state elected officials, he’ll prioritize enforcement within six months of taking office in 2027. He said any recovered money could be returned to Ohioans. 

“We’re going to go so fast the fraudsters won’t know what hit them,” Ramaswamy said.

Ramaswamy announced his plan on Tuesday at a press conference in Columbus, where he was flanked by other state Republicans, including his running mate, Ohio Senate President Rob McColley, who have led Ohio’s government for years. 

Notably absent, though, were the two Republican officials who currently oversee the state’s anti-fraud efforts for its massive Medicaid program –  Republican Gov. Mike DeWine, who will leave office at the end of the year due to term limits, and Attorney General Dave Yost, who steps down next month. Spokespeople said the governor wasn’t invited to attend, while Yost had a scheduling conflict.

Ohio’s state government has faced intense criticism recently from conservative media and Republicans after the Daily Wire, a national conservative publication, published a series of articles criticizing the state’s anti-fraud efforts, particularly surrounding aides who deliver care in private homes. 

State Republicans largely responded to the criticism by blaming DeWine’s administration. 

Past Republicans have vowed to clean up the state’s Medicaid program – including DeWine and his predecessor, former Gov. John Kasich, who restructured the state’s Medicaid administration when he took office in January 2011. 

Asked about that history Tuesday, Ramaswamy said he’s not looking to lay blame with anyone.

Rather, he said his background as a young healthcare entrepreneur positions him to approach the issue with a fresh perspective.

“I don’t view myself as a caretaker temporarily occupying a warm seat in the governor’s office until someone else comes along, so that 10 years from now you can ask a future governor the same question about me,” he said. “Now we’re doing things differently.” 

More on why Medicaid fraud is a hot topic

In recent years, state officials have viewed fraud as an unfortunate fact of life in the state’s Medicaid program, which accounts for roughly one-third of all state spending. 

The program costs roughly $46 billion annually, with the costs split between the federal and state governments, and provides healthcare to 3 million Ohioans, about one-quarter of the state’s population. Fraud can occur when providers bill the government for services they don’t actually provide. 

State legislators have been going back and forth with DeWine for years seeking more oversight over Medicaid as the program has grown more and more expensive despite stagnant enrollment numbers. Since becoming governor in 2019, DeWine has vetoed multiple measures that would require additional audits of the program, describing them as duplicative or possibly in violation of federal privacy laws.

Ohio Auditor Keith Faber, a Republican whose main job is to check government spending for waste, fraud and abuse, at times has flagged weak fraud controls in the state Medicaid program. During a special legislative committee hearing on Medicaid fraud in March, he highlighted the state Medicaid department’s spending on home health aides, saying a disproportionately large share of the $1.6 billion the state spent on those services came from Franklin County. 

The hearing drew little wider attention. But Medicaid fraud emerged as a front-burner issue after the Daily Wire, a publication run by conservative pundit Ben Shapiro, published a series of articles that focused on potential home health care fraud in Franklin County. The articles said the state had overlooked obvious red flags for some providers, including some with the past fraud convictions. 

The series was burnished by a previously unavailable, massive trove of federal Medicaid spending data released by the federal Department of Government Efficiency. The articles  focused on Columbus’s Somali immigrant community, which has been a preoccupation on the political right after members of the Somali community in Minneapolis were embroiled in a scandal involving fraud in Minnesota’s Medicaid-funded childcare program.

Democrats have questioned whether the Daily Wire’s reporting singles out fraud among immigrants while overlooking where it exists in other communities, and said any issues it may have found are the fault of Republicans who run the state government.

Democrats also have accused Republicans of highlighting fraud as a way to discredit Medicaid, which faces looming massive federal cuts under President Donald Trump’s signature spending bill. 

Ramaswamy invited the author of The Daily Wire series, Luke Rosiak, to speak at Tuesday’s press conference.

“I’m just a DC reporter,” he said. “The only reason I’m here in Ohio is that DOGE released a database a couple months back of Medicaid spending.”

Faber, who now is running to replace Yost as state attorney general against Democrat John Kulewicz, also attended Tuesday’s news conference. 

“This is what happens when you have a department that thinks it’s more important to get benefits out the door than it is to make sure the right people are getting those benefits,” Faber said.

McColley and House Speaker Matt Huffman also spoke, saying the legislature plans to pass new anti-fraud measures within the next month.

More on Ramaswamy’s proposal

On Tuesday, Ramaswamy said Ohio currently doesn’t have enough incentive to fight fraud, since two-thirds of the program’s funding comes from the federal government and one-third from the state government. That means the state only keeps one-third of the money it gets from fraud recovery.

But he said Ohio would be more motivated if it could keep more of the money. Doing this will require getting special permission from the U.S. Centers for Medicare and Medicaid Services. Ramaswamy said President Donald Trump’s administration has been open to state efforts to reduce program spending. He also said he got positive feedback when he discussed the idea last week with Trump’s CMS Director Dr. Mehmet Oz. 

The Trump Administration approved a similar plan for Tennessee, allowing the state to keep half of the savings it realized through general reforms in the program. Ramaswamy said he’d use Ohio’s recovered money to defray rising healthcare costs.

“We should take advantage of this as a state, and when you have the unique background and experience, but also unique relationships to make that happen, this is going to work well for the people of Ohio,” Ramaswamy said. 

He also wants to consolidate Ohio’s Medicaid administration, which he said is too sprawling, with 10 different agencies involved with processing payments. Streamlining and centralizing the program would make it more efficient, he said.

Ramaswamy said doing so would also make the program more transparent. He didn’t describe how. But Medicaid payments are currently complicated to obtain, due to privacy restrictions and existing interpretations of state public records law. 

In a brief interview after the event, McColley, Ramaswamy’s running mate, called the program a “black box” and said state lawmakers have been frustrated in their attempts to learn more about how Medicaid money is spent.

“We haven’t been able to get nearly as much information as we should be able to get,” McColley said. “It’s always just asking for this, that, and the other thing from us, without having a two-way street. I would expect that the new Department of Medicaid is going to be one that’s far more transparent than it is right now.”

Asked about Ramaswamy’s press conference on Tuesday, Dan Tierney, a spokesperson for the governor, said Ramaswamy’s proposal to increase how much Ohio can recoup for fraud recovery is an interesting proposal worth considering.

But, he said the state’s Ohio Medicaid Fraud Control Unit has been praised for years as among the best in the country by the federal government’s anti-fraud watchdog agency, the U.S. Office of Inspector General. 

Yost currently oversees the unit, but DeWine oversaw it while he served as attorney general from 2011 through 2018.

Tierney said some of the providers flagged in the Daily Wire series, which contained data from 2018 to 2024, already are under investigation, and some are inactive. 

DeWine also announced last week new anti-fraud measures in the Medicaid program, including reversing a 2024 decision to make GPS tracking of home health aides optional. 

“It’s an interesting proposal,” Tierney said. “But our point is we have always been working to fight fraud, waste and abuse, regardless of whatever the share rate is because we’ve been working on that consistently during his time as AG and during his time as governor. “ 

Amy Acton responds

Ramaswamy is running in the November election against Dr. Amy Acton, a Democrat who was DeWine’s state health director from 2019 through June 2020, when she resigned a few months into the COVID-19 pandemic.

The Acton campaign portrayed Ramaswamy’s new proposal as meaningless. Acton and other Democrats have also repeatedly pointed out how he called the program “a mistake” in a podcast interview in 2024. 

“As Governor, Dr. Amy Acton will prioritize rooting out Medicaid fraud, waste, and abuse while ensuring that Ohioans can access affordable, quality healthcare,” Addie Bullock, spokeswoman for the Acton campaign, said in a statement. “Dr. Acton is fighting to lower healthcare costs, protect Medicaid and Medicare access, and end the rampant corruption in Ohio’s statehouse which has allowed fraud, waste, and abuse for far too long. No matter how many scam policies he rolls out, Ohioans know that Vivek Ramaswamy is an out-of-touch billionaire who thinks Ohioans are ‘lazy’ and ‘mediocre,’ calls affordability a ‘buzzword’ and says Medicaid and Medicare is a ‘mistake.’”

Acton recently commented on the Daily Wire reports. Talking with reporters on May 5, she said she will use artificial intelligence to pore over state data and find potential fraud, calling the idea “Buckeye AI.”

“We will be using every tool available. I believe we can look 10 years out from now and work our way back to this moment,” Acton said. “We didn’t get here overnight.”