Find Corporate Waste

Category: Medicaid Fraud

  • Michigan Health Care Provider Ordered to Pay $334,807 to Settle False Claims Act Allegations

    Michigan Health Care Provider Ordered to Pay $334,807 to Settle False Claims Act Allegations

    In the Eastern District of Michigan, M&Y Care, LLC, a Michigan-based home health provider, has agreed to pay $334,807.20 to resolve allegations that it defrauded the Medicare and Medicaid programs by billing for services rendered by unqualified staff.

    According to the Department of Justice, M&Y Care caused the United States Government to be billed for services provided by unqualified staff. Using the incorrect CPT code, G0156, which refers to a home health aide, they defrauded the federal government for services at a reimbursement rate higher than the non-skilled rate to which their employees were entitled.

    The misconduct came to light thanks to a False Claims Act lawsuit filed under the law’s qui tam provisions. The investigation was prompted by a whistleblower complaint under the False Claims Act (FCA), showing the critical role private citizens play in holding corporations accountable for wasting our money.

    At Find Corporate Waste, we applaud this outcome and the whistleblower who made it possible. Every time a company siphons money from Medicare or Medicaid, they are not just defrauding a system—they are stealing from the sick, the elderly, and the taxpayer.

    We are committed to ensuring that fraud like this doesn’t go unanswered.

    If you have information about misconduct involving government programs or contracts, visit our page on how whistleblowers protect public funds. You might be the reason the next $300,000 gets returned to the American people.

    • Census Bureau Manager Took $790K in Contract Kickbacks

      A former Census Bureau program manager was sentenced to two years in prison for steering a federal contract to a relative’s company in exchange for $790,000 in kickbacks.

    • Mass. Man Kept $67K Meant for DEAD Social Security Recipient

      A Massachusetts man kept Social Security and pandemic payments flowing for six years after the beneficiary died.

    • Illegal Voting Case Raises Questions About Election-System Certifications

      An Australian lawful permanent resident allegedly registered and voted in two federal elections. The criminal case should trigger a second inquiry: what did election-system contractors certify their technology could prevent, detect or validate?

    • $89 Million Payroll Fraud Scheme Exposes a Taxpayer-Theft Pipeline

      The IRS says a construction-sector cash payroll scheme moved roughly $89 million through shell companies and caused more than $38 million in federal tax losses.

    • SSM Health Pays Nearly $1M After Pharmacy Copay Waiver Allegations

      A $1 million Missouri settlement shows why routine copay waivers are not harmless customer service. When federal programs pay inflated prescription costs, the False Claims Act becomes the recovery tool.

    • North Carolina Tax Preparers Turned Pandemic Relief Into a $14M Fraud Scheme

      Eight North Carolina return preparers have now pleaded guilty in a pandemic-relief tax fraud scheme that caused the IRS to pay nearly $13.9 million in fraudulent refunds.

    • DOJ’s $6.5B Health Care Fraud Takedown Shows Why FOCUS Matters

      The DOJ’s 2026 National Health Care Fraud Takedown is a roadmap for how public data, billing anomalies, exclusion records, and interagency screening can identify taxpayer exposure before fraud becomes unrecoverable.

    • Brooklyn Adult Day Care Operators Accused in $38M Medicaid Kickback and False-Billing Scheme

      Prosecutors reportedly allege APNA and Ashiana billed Medicaid for adult day care services that were not provided, using kickbacks, false attendance records, and shell-company transfers.

    • Alabama Defense Contractor Pays $507K to Resolve False Claims Act Cybersecurity Allegations

      DOJ says Alabama defense contractor LOGZONE Inc. agreed to pay $507,144 to resolve FCA allegations tied to cybersecurity requirements on Navy contracts. The case shows how DFARS/NIST compliance failures can become False Claims Act exposure when federal payment claims are involved.

    • Aquatherm Pays $1.35M Over PPP Eligibility Allegations

      Aquatherm agreed to pay $1.35 million to resolve False Claims Act allegations that it improperly obtained and received forgiveness for a PPP loan despite exceeding the 300-employee limit when affiliates were counted.

  • DOJ-HHS Launch New Initiative to Combat Healthcare Fraud

    DOJ-HHS Launch New Initiative to Combat Healthcare Fraud

    July 2, 2025

    Washington, D.C.


    In a decisive move to enhance the fight against healthcare fraud, the U.S. Department of Justice (DOJ) and the Department of Health and Human Services (HHS) have taken significant action. They have launched the DOJ-HHS False Claims Act Working Group.

    This strategic alliance formalizes long-standing cooperation between the two agencies.

    It also shows how the False Claims Act (FCA) is used. This law protects federal healthcare programs from fraud, waste, and abuse.

    The Working Group will concentrate enforcement in seven key areas:

    • Medicare Advantage fraud, such as upcoding and inflated risk scores
    • Drug and device pricing manipulation, such as undisclosed rebates and improper discount arrangements
    • Access to care violations, including non-compliant provider networks
    • Kickback schemes, involving drugs, medical devices, and durable medical equipment
    • Defective medical devices that compromise patient safety
    • Electronic Health Records abuse, such as system manipulation to boost Medicare billing
    • Data-driven investigations, powered by cross-agency analytics and audit findings

    The new Working Group encourages whistleblowers to report false claims involving federal healthcare dollars related to specific enforcement priorities.

    At Find Corporate Waste, we spotlight whistleblower-driven accountability.

    If you become a relator under the False Claims Act, your role would expose fraud and recover taxpayer dollars.

    Becoming a relator is a serious decision.

    If you have inside information on healthcare contracts or schemes, we’re here to assist you.

    Report Fraud

  • How States Game the System: Medicaid Fraud and the FMAP Loophole

    Medicaid was originally created as a partnership between the federal government and individual states. The concept was simple: every time a state spends a dollar, the federal government matches a portion of that investment.

    This is known as the Federal Medical Assistance Percentage (FMAP).

    Over time, some states discovered a way to manipulate the system by shifting the burden entirely to the federal government while padding their own budgets.

    How Medicaid Fraud Works

    1. The state taxes hospitals or nursing homes.
    2. The state pays this tax back to the provider as Medicaid reimbursements.
    3. The federal government matches a percentage of the returned funds through FMAP.
    4. The provider gets their money + the FMAP.
    5. The state contributes nothing, while the federal government is on the hook.

    Why It All Adds Up to a Big Problem

    This fraud is one of the major factors contributing to the systemic weakness of our entire healthcare system.

    When states are allowed to run these schemes, Medicaid becomes more expensive, draining money away from the people who actually need help.

    Instead of creating a safety net, the system becomes a slush fund for state coffers—and the federal government (read: taxpayers) gets stuck with the tab.

    At Find Corporate Waste, we dig deep into these kinds of backdoor deals because we believe in a system that’s honest, accountable, and actually works for the people it’s supposed to serve. Not one that lets bureaucrats and politically connected hospitals game the rules for a payday.

    But here’s the thing—we can’t do it alone.

    If you’ve seen this kind of scheme from the inside—maybe you work in healthcare, government, or finance—you might be sitting on information that could make a real difference. Thanks to the False Claims Act, whistleblowers who step forward not only help protect public funds—they may also be eligible for a financial reward if the government recovers money based on their tip.

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