On March 7, 2025, 39-year-old Rick Clemmer was found dead in his East Side St. Paul, Minnesota apartment after several days without contact from medical providers paid to oversee his care. The medical examiner attributed his death to an enlarged heart. But for his mother, Mickey Clemmer, that explanation left the most troubling question unanswered: how did a man enrolled in a Medicaid-funded program designed to provide daily supervision end up entirely alone?
Rick Clemmer had long struggled with severe mental illness and substance-use disorder. For most of his adult life, he lived in regulated environments where court-ordered treatment plans and routine monitoring helped keep him stable. In the summer of 2024, he transitioned to independent housing through Minnesota’s Integrated Community Supports (ICS) program—a Medicaid benefit intended to provide daily, one-on-one assistance with medication adherence, safety checks, meal preparation, and basic household management for individuals with complex behavioral health needs.
According to reported billing records, his provider, Ultimate Home Health Services LLC, charged Medicaid roughly $462 per day—equivalent to about 12 hours of care. That is more than double the average daily Medicaid expenditure per beneficiary in Minnesota. Yet according to family accounts, those services were never delivered. Clemmer died unnoticed while payments continued. His mother has described the episode not as a paperwork failure, but as abandonment financed by taxpayer dollars.
Whether prosecutors ultimately pursue charges will be determined through a formal investigation. But the circumstances expose a broader and increasingly documented vulnerability in Minnesota’s public-benefits infrastructure: insufficient transparency, fragmented oversight, and slow enforcement in healthcare programs that move billions of taxpayer dollars each year. How could someone enrolled in a program intended for constant supervision be left so completely alone?
The answer to that question illustrates how administrative failures quickly become personal tragedies.
Federal authorities have spent years examining irregularities in Minnesota’s Medicaid billing, child-nutrition assistance, and disability-services programs. Public court filings and Department of Justice statements describe alleged schemes involving inflated claims, phantom services, and shell providers. Collectively, investigators have estimated potential losses in the hundreds of millions of dollars, with some assessments exceeding $9 billion across multiple programs since 2018.
This is not merely fiscal waste. It is a failure of human dignity. Every fraudulent claim diverts resources from patients who depend on reliable care. Every stolen dollar represents a service not delivered. When oversight fails, families lose loved ones, legitimate clinics are swept into payment freezes, frontline healthcare workers face uncertainty, and public trust in the healthcare safety net erodes. This is more than greed - it is a disregard for life.
Securing public-benefit programs and getting rid of fraud is not a political talking point; it is a public-safety imperative. Research published in the Journal of Healthcare Quality shows that transparency measures, including standardized public reporting of provider performance, significantly reduce adverse patient events. Transparency is not bureaucratic overhead—it is a proven safeguard.
A taxpayer-first, or “Minnesota First,” approach to healthcare governance begins with stewardship. Taxpayers fund Medicaid with the expectation that dollars translate into real services delivered to real people, particularly the disabled, the elderly, and those with serious mental illness. Minnesotans are generous and compassionate, but generosity cannot become an excuse for complacency. Accountability depends on visibility into how care is delivered, who delivers it, and whether promised services actually occur.
Transparency must be built directly into program design, beginning with cooperation—not resistance. First, cooperation with federal investigators should be standard practice. Fraud schemes often cross jurisdictional lines and coordinated task forces shorten investigations and deter repeat offenders. Accountability is not partisan; it is administrative competence.
Second, transparency in ownership and management must be mandatory. Medicaid providers should be required to disclose beneficial owners and affiliated entities to prevent bad actors from reemerging under new corporate names. Public registries of licensed providers and enforcement actions would empower families to make informed decisions.
Third, routine independent audits must become the rule rather than the exception. Claims data should be analyzed in real time for red flags such as unusually high per- patient billing or implausible hours of care.
Fourth, real-time service verification should be universal across home- and community-based services. Electronic visit-verification systems can confirm when staff arrive, how long they stay, and whether required services are completed. Missed visits should trigger immediate alerts—not audits conducted months later.
Finally, payment-suspension protocols must be swift and fair. When credible evidence of abuse emerges, reimbursements should stop immediately, with expedited appeals for legitimate providers. Transparency protects not only patients and taxpayers, but it also protects honest clinicians whose livelihoods suffer when fraud goes unchecked.
Rick Clemmer’s case may ultimately be decided in court. But the lesson is already clear: when transparency fails, people die. Restoring confidence in public healthcare programs requires structural transparency, rigorous oversight, and leaders willing to prioritize competence over theatrics.
Healthcare transparency is not optional. It is the foundation of trust—and, in too many cases, the difference between life and death.
Zachary Freimark serves as executive director of the America First Policy Institute’s Minnesota state chapter.