Opinion: The data to find Medicaid fraud already exists, but no one is using it

Last month, the Department of Justice announced its 2026 National Health Care Fraud Takedown: 455 defendants charged and $6.5 billion in alleged false claims, with cases spanning 56 federal districts. The number of defendants charged was nearly 40 percent higher than in the prior year.

This week, the House Energy and Commerce Subcommittee on Oversight and Investigations convened a hearing on exactly this problem, taking testimony from state Medicaid directors in California, Minnesota, New York and Ohio.

These announcements follow a familiar rhythm: Charges are filed, hearings are held and the numbers get bigger. What does not change is the underlying vulnerability…

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