The Centers for Medicare and Medicaid Services is also taking a more aggressive approach toward suspected fraud, including withholding or deferring federal Medicaid payments to states while investigations are ongoing. Likewise, President Donald Trump recently named Vice President JD Vance as the administration’s anti-fraud czar.The scrutiny is long overdue.
For years, Medicaid’s defenders have treated fraud and improper payments as an unfortunate but manageable byproduct of a massive government program. But the sheer number of recent scandals suggests a more systemic problem: Medicaid has become a magnet for organized fraud in many parts of the country.
In New York, investigators recently uncovered widespread fraud in the state’s Medicaid transportation system, with some drivers allegedly scamming taxpayers out of as much as $196 million through fake trips, improper documents, and other billing abuses.
In Pennsylvania, a business owner was recently sentenced for perpetrating Medicaid fraud and money laundering schemes that prosecutors said stole millions from taxpayer-funded healthcare programs, including Medicaid. And in Wisconsin, the owner of a Milwaukee prenatal care coordination company was sentenced to five years in prison for fraudulently billing Medicaid for more than $2.6 million in services that were never provided.
