The U.S. Department of Justice announced an Ohio anti-fraud initiative that combines new federal-state data sharing and coordination measures with charges against nine defendants in cases alleging more than USD 42 million in fraud. The cases involve alleged Medicaid and behavioral health billing fraud and Paycheck Protection Program loan fraud. Separately, three defendants were detained and two others are awaiting extradition in an alleged USD 15 million romance scam, and the Federal Bureau of Investigation (FBI) launched a Most Wanted Fraudsters list to publicize fugitive fraud suspects. The cooperation package includes an inaugural Fraud Division-State Partnership Roundtable, a data-sharing agreement giving the Department's Fraud Division access to Ohio corporate registrant data to trace ownership links across clinics, labs and billing entities, continued cross-designation of Ohio prosecutors into federal health care fraud strike forces and U.S. Attorneys' Offices, monthly coordination of new Medicaid fraud investigations, and Centers for Medicare & Medicaid Services referrals through the Health Care Fraud Data Fusion Center. In the announced cases, four defendants in the Southern District of Ohio were charged over an alleged USD 30 million behavioral health scheme, one defendant was charged in Butler County over an alleged USD 12 million Medicaid billing scheme, and four defendants were charged in another Southern District case over alleged fraud on COVID-19 relief programs exceeding USD 1.4 million. The romance fraud case in the Northern District of Ohio allegedly targeted more than 130 victims using dating sites, social media and artificial intelligence-driven video tools, with more than USD 3 million in assets seized. The Department encouraged other states to form similar partnerships with the Fraud Division, presenting the Ohio roundtable as an inaugural model for wider federal-state fraud enforcement.