Federalist Radio Hour ‘Fraught With Fraud’: Exposing States’ Medicaid Money Dump
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Feb 27, 2026 John Hart, CEO of Open the Books, a government-spending transparency leader, discusses exploding Medicaid in‑home payments and state-level fraud surges. He highlights massive payout spikes in Pennsylvania, New York, Minnesota, and California. Topics include systemic incentives that invite abuse, data-driven detection using AI, and building citizen tools and transparency to hold officials accountable.
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Medicaid Personal Care Payments Exploded After 2018
- Federal Medicaid payments to personal assistance services exploded after 2018, revealing structural incentives for fraud.
- Open the Books used a DHS data dump of 270 million payments (2018–2024) to show dramatic spending growth like Pennsylvania's 10,000% surge.
Himal Patel Ghost Provider Fraud Example
- John Hart highlighted the Himal Patel case as an example of ghost home health schemes that siphoned millions from Medicaid.
- Patel set up fake home health providers and was charged with wire fraud after allegedly milking Medicaid at massive scale.
Government Incentives Make Fraud Inevitable
- Hart argues systemic incentive problems make government spending especially vulnerable because it is 'someone else's money on someone else.'
- He ties that to the administrative state's growth and says addressing fraud requires debating the scale of entitlements, not just prosecutions.