Former Fortune 30 healthcare CFO. Healthcare reform enjoyer. #MedicaidFraud Author. I share my stock insights since I live off of them. Not financial advice.
Seattle, WA
Joined November 2009
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Check out my latest article: REDUCING LONG-TERM COSTS WITH ‘IN LIEU OF’ SERVICES. linkedin.com/pulse/reducing-… via @LinkedIn
A Rhode Island dentist billed Medicaid for procedures performed on patients who had died months or years earlier. The scheme went undetected for three years because no one was cross-checking death records against claims data. #MedicaidFraud
A Chicago home care agency created fictitious care plans signed by physicians who had never met the patients. The doctors had no idea their names were being used until federal investigators called. #MedicaidFraud
A Georgia mental health clinic billed Medicaid for group therapy sessions with up to 60 patients at a time. The legal limit is 12. The clinic collected millions before a whistleblower came forward. #MedicaidFraud
A Missouri pharmacist billed Medicaid for brand name drugs while dispensing generics, pocketing the difference for years. The scheme is called product substitution fraud and it is more common than most people know. #MedicaidFraud
A Los Angeles DME network billed Medicare and Medicaid between $2 and $10 billion before federal agents shut it down. It was one of the largest healthcare fraud schemes ever prosecuted. #MedicaidFraud
Eight people were arrested in Southern California in April 2026 for enrolling hospice patients who were not terminally ill and billing federal programs for years of unneeded end of life care. #MedicaidFraud
A multistate hospice chain enrolled patients who were not terminally ill, collected capitation payments for years, and discharged patients when federal auditors arrived. The scheme spanned six states. #MedicaidFraud
A Pennsylvania personal care agency submitted timesheets for caregivers who were incarcerated, working other jobs simultaneously, or had already died. Part of the $4 million scheme charged in August 2026. #MedicaidFraud
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A Texas psychiatrist billed Medicaid for 24 hours of patient sessions in a single day. The claims processing system approved every one of them automatically. #MedicaidFraud
A New York transportation company billed Medicaid for thousands of rides to medical appointments. Investigators found many of the patients had no scheduled appointments on the dates billed. #MedicaidFraud
Minnesota’s Feeding Our Future scandal involved 14 separate Medicaid and nutrition programs, potentially $9 billion in fraudulent claims, and a network of shell companies spanning multiple continents. #MedicaidFraud
A California man billed Medi-Cal $270 million in fraudulent prescription drug claims over just 11 months before federal prosecutors caught up with him. That is roughly $900,000 per day. #MedicaidFraud