The Trump administration has paused over $1 billion in federal Medicaid payments to California and Minnesota, with Health Secretary Robert F. Kennedy Jr. citing suspected fraud and noncompliance. The states must provide documentation to receive the withheld funds.
The Department of Justice filed a lawsuit against New York state health officials alleging they rigged the bidding process to award a contract for managing the state's Medicaid homecare program to Georgia-based Public Partnerships through a 'sham bid process' in late 2024.
Massachusetts filed a lawsuit against a UnitedHealth insurance unit, accusing it of defrauding the state's Medicaid program (MassHealth) by more than $100 million through inflating patient risk scores to make older patients appear sicker than they were.
A key GOP lawmaker is investigating whether the American Medical Association's medical billing codes are contributing to healthcare fraud, broadening Republican efforts to combat fraud in the healthcare system.
The Department of Justice has announced the creation of a new West Coast Health Care Fraud Strike Force to investigate fraud targeting Medicare and other government health programs in western states including Nevada, responding to criminals following retiree migration patterns.
