Medicaid fraud defies partisan blame-mongering

Government officials at both the state and federal levels have provided so little concrete information that I'm finding those questions surprisingly difficult to answer. Consider four more basic questions. Advertisement 1: What exactly do we mean by 'Medicaid fraud'? The federal fraud cases announced since September involving Medicaid services that state officials designated 'high risk' were limited to four services: autism services, added to Medicaid in 2015; Individualized Home Supports, first covered in 2018; Housing Stabilization Services, first covered in 2020 and terminated in 2025; and Integrated Community Services, first covered in 2021. Medicaid, jointly funded by the state and federal governments, pays for thousands of services. If the fraud cases involving the state's 'high risk' services are focused on four relatively new ones, is 'Medicaid fraud' the most useful description of the problem? Or are we dealing with vulnerabilities in a small number of particular programs? 2: How much money are we actually talking about? Former Acting U.S. Attorney for Minnesota Joe Thompson estimated last December that fraud could total $9 billion. The Trump administration has said it will withhold $2 billion in federal Medicaid matching funds from Minnesota over the course of a year. A year ago, Thompson's estimate was $1 billion. Yet by my count, the fraud alleged in DOJ charges announced since September totals about $97 million. Minnesota's attorney general, meanwhile, says his office has recovered more than $90 million since 2019. Even if we assume there is no overlap between the cases DOJ has charged and those for which the attorney general claims recoveries — probably an erroneous assumption — that would put the combined figure at $187 million.