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Medicaid fraud cases

Federal prosecutions and settlements involving Medicaid, compiled from Justice Department announcements, with a state-by-state breakdown.

DOJ announcements
302
Since January 20, 2025
Sentencings
81
Civil settlement 72 · Charged 69
Largest amount named
$556M
settlement · 2026

Medicaid fraud cases by state

Where to report Medicaid fraud

Full steps and reward rules: how to report Medicaid fraud.

Latest announcements

DateAnnouncementStateStageAmount
2026-10-20Illinois Laboratory Owner Charged in $66M COVID-19 Testing Fraud SchemeIllinoisCharged$66.2M
2026-10-16Connecticut Physician and His Practices Pay More Than $860K to Settle False Claims Act AllegationsConnecticutCivil settlement$867K
2026-10-15Charlotte Man Pleads Guilty to Health Care Fraud for Stealing Hundreds of Thousands from the North Carolina Medicaid ProgramNorth CarolinaPleaded guilty—
2026-10-09Maryland Man Facing Federal Indictment for Role in COVID-19 Healthcare Fraud Scheme Totaling More Than $100MMarylandCharged—
2026-10-08Minnesota Woman Convicted in $3.6M Scheme to Defraud Medicaid Housing Services ProgramMinnesotaConvicted at trial$3.6M
2026-10-02Social Adult Day Care Owner Pleads Guilty to $65M Medicaid FraudNew YorkPleaded guilty$65M
2026-10-02Doctor Convicted for Conspiring to Distribute Over 2 Million Stimulant PillsMulti-stateConvicted at trial—
2026-10-01Worcester Man Indicted for Snap FraudMassachusettsCharged—
2026-09-28Iowa Attorney Sent to Federal Prison in Medicaid Fraud Scheme Involving His Rolls-Royce Vehicle CollectionIowaSentenced—
2026-09-24Chief Operating Officer Pleads Guilty for Role in $500M COVID-19 Test Billing FraudMichiganPleaded guilty—
2026-09-15Peoria Man Charged with Defrauding AHCCCSArizonaCharged$33M
2026-09-14Woman Sentenced in Cross-Border Identity Theft and Immigration Fraud SchemeCaliforniaSentenced$9K
2026-09-11Brooklyn Adult Daycare Owner Sentenced to Prison for Leadership Role in $64M Medicaid Fraud SchemeNew YorkSentenced$56M
2026-09-11Arrested at Airport, Man Voluntarily Returns to Minnesota to Face Charges of Defrauding $1.3 Million in Housing Stabilization Services FundsMinnesotaCharged$1.3M
2026-09-09Brooklyn Adult Daycare Owner Sentenced to 76 Months in Prison for Leadership Role in $68 Million Medicaid Fraud SchemeNew YorkSentenced$56M
2026-09-08Illegal Alien Sentenced for Passport and Benefit FraudMassachusettsSentenced$305K
2026-09-08Illegal Alien Pleads Guilty to Healthcare Benefit Fraud and Aggravated Identity TheftMassachusettsPleaded guilty$80K
2026-08-26Woman Charged with Health Care Fraud After Submitting False Claims to Utah Medicaid and Receiving Millions in PayoutUtahCharged—
2026-08-25Unknown Man Sentenced To Five Years In Prison For Using Identity Of Deceased Child For 25 Years To Obtain Nearly $300,000 In Government BenefitsIdahoSentenced—
2026-08-25Lewiston Man Sentenced for Aggravated Identity Theft and Benefits FraudMaineSentenced$36K
2026-08-20Four Members of the "War Room" Charged in Connection with $12M Medicaid Fraud SchemeNew YorkCharged$12M
2026-08-18United States and State of Illinois File Complaint in Intervention in False Claims Act Lawsuit Against Chicago-Area Medical Practice and Billing Company for Allegedly Submitting Fraudulent Medicare and Medicaid ClaimsIllinoisOther$5.2M
2026-08-17U.S. Attorney's Office Files Civil Complaint against Texas Corporation and North Carolina Man for Allegedly Defrauding MedicareSouth DakotaCharged—
2026-08-17Safire nursing homes agree to pay $9 million to resolve fraudulent Medicare and Medicaid billing allegationsNew YorkCivil settlement$9M
2026-08-10Veloxis Pharmaceuticals Agrees to Pay Over $46M to Resolve Criminal and Civil Liability for Kickback SchemesMassachusettsCivil settlement$46M

Source: U.S. Department of Justice press releases, classified by WHIP Reward. Each row is one press release; the same case can appear at several stages, so amounts should not be added. Charged cases are allegations. Search all 302 in the database.

Frequently asked questions

Where do I report Medicaid fraud?

HHS Office of Inspector General (1-800-HHS-TIPS (1-800-447-8477)): Fraud in Medicare, Medicaid and other HHS programs. Your state's Medicaid Fraud Control Unit: State unit, usually in the Attorney General's office, that prosecutes provider fraud. America.gov/fraud (WHIP reward portal): Required route if you want a WHIP award of $10,000–$30,000.

Can I get a reward for reporting Medicaid fraud?

Yes. HHS / Centers for Medicare & Medicaid Services programs are covered by the federal WHIP program, which pays $10,000–$30,000 per tip that leads to criminal charges. Larger cases can be brought under the False Claims Act, which pays 15–30% of what the government recovers.

Sources

  1. U.S. Department of Justice: Whistleblower Rewards Program
  2. HHS-OIG: Report fraud
  3. HHS-OIG: Medicaid Fraud Control Units
  4. U.S. Department of Justice press releases (justice.gov/news)