WASHINGTON — A House committee has launched an investigation into alleged Medicaid fraud in 10 states — including New York and California — demanding records “to ensure program integrity in states nationwide,” The Post can reveal.
The letters, sent March 3 by GOP leaders on the House Energy and Commerce Committee, asked for records and communications from the governors and leaders of state health agencies of New York, California, Colorado, Massachusetts, Maine, Nebraska, Oregon, Pennsylvania, Vermont and Washington State.
Each of the missives drew attention to recent reports or prosecutions of fraudsters in the respective states.
In New York, for example, two individuals linked to adult day cares in Brooklyn and a home health care firm pleaded guilty in January to defrauding taxpayers out of $68 million in Medicaid funds.
Another scheme cited $120 million allegedly stolen from Medicaid and Medicare funds to the owners of Queens-based adult daycare centers and a pharmacy who were taking kickbacks.
The Empire State spent $115.6 billion on Medicaid for almost 7 million people in fiscal year 2025, but the program “has continued to grow at unsustainable levels,” according to Gov. Kathy Hochul’s budget plan for this fiscal year.
Other letters to California, Colorado, Pennsylvania and Nebraska noted massive percentage increases in spending on Medicaid services in recent years.
“Fraud shouldn’t be a partisan issue,” Energy and Commerce Chairman Brett Guthrie (R-Ky.) said in a statement. “It’s our most vulnerable Americans who are most at risk from fraudsters diverting precious resources intended for critical, needed care.”
“We owe it to our fellow Americans to preserve the Medicaid program for those that need it most, and states have an important role to play in ensuring that Medicaid programs operate with integrity,” he added. “The Committee will continue to combat rampant waste, fraud, and abuse across the entire country.”
The letters all cited reports of fraudsters bilking taxpayer funds in Minnesota — as well as Trump administration probes that recently led to the withholding of more than $250 million in Medicaid funding.
That fraud was perpetrated through “overbilling, falsifying records, identity theft, and phantom claims in Medicaid social service and health programs for the elderly and disabled, children with autism, people struggling with substance use disorders, and homelessness,” wrote Guthrie and two other GOP subcommittee chairmen, Rep. John Joyce (R-Pa.) and Rep. Morgan Griffith (R-Va.).
The House Energy and Commerce Committee’s probe comes after a hearing early in February that heard testimony from experts about kinds of fraud schemes — including those with “high rates” of abuse such as Applied Behavioral Analysis (ABA), services for children with Autism Spectrum Disorder (ASD), substance abuse treatment centers, home and community based services and more.
Certified fraud examiner Jessica Gay told the House committee that the vulnerable programs “should be on every state’s radar.”
“If a state isn’t monitoring ABA services closely, they are likely missing a considerable area where FWA is committed,” Gay said.
“Medicaid fraud robs both taxpayers and patients, and we will pursue it wherever it hides,” Joyce said in a statement.
“Republicans in Congress will continue to do the necessary legwork to investigate allegations of waste, fraud and abuse within our Medicaid system,” added Griffith.
Reps for the governors’ offices and state health agencies in the states did not immediately respond to a request for comment.
