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.

    • Arkansas Lab and Owners Pay $30M Over Alleged Kickback-Fueled Testing Scheme

      Advanced Pathology Solutions and its owners agreed to pay $30 million to resolve allegations that kickbacks generated improper federal health care claims.

    • Massachusetts Man Admits to Taking Nearly $88K in Stolen Social Security Benefits

      A Massachusetts man admitted stealing nearly $88,000 in Social Security disability payments intended for a deceased beneficiary.

    • DOJ Sues to Stop Alleged Fraud in New York’s $10 Billion Medicaid Home-Care Program

      New York and Public Partnerships LLC misled the public, mishandled CDPAP’s transition, and allowed millions in unauthorized Medicaid-funded profits.

    • Seven Men Arrested in $205K COVID Relief Fraud Case

      Seven Las Vegas men were indicted in an alleged $205,639 PPP and EIDL fraud case involving false information and fake documentation, according to DOJ and SBA-OIG.

    • Utah Men Charged in Alleged $5.5M IRS and SBA COVID-Relief Fraud Scheme

      Federal prosecutors say two Utah men helped run a fictitious payroll scheme that allegedly defrauded the IRS and SBA of more than $5.5 million.

    • Former Intelligence Contractor Pleads Guilty in Kickback Scheme

      A former Intelligence Community contractor admitted taking at least $510,000 in kickbacks tied to government procurement, according to the DOJ.

    • North Carolina Woman Charged in Immigration and VA Disability Fraud Case

      A North Carolina woman was charged with immigration fraud and VA disability fraud after prosecutors alleged a sham marriage was used to obtain immigration benefits and increased federal benefit payments.

    • Circle Medical to Pay $3.325M Over Alleged False Healthcare Claims

      Circle Medical, a San Francisco telehealth company, will pay $3.325 million to resolve allegations that claims identified providers who did not actually provide or supervise the billed services.

    • Ahold Delhaize USA to Pay $40M Over Allegedly Inflated Pharmacy Prices

      Ahold Delhaize USA will pay $40 million to resolve DOJ allegations that its supermarket pharmacies reported inflated “usual and customary” drug prices to Medicare Part D, Medicaid, and TRICARE.

    • Maryland Man Gets 9 Years for EIDL Money Laundering Scheme

      A Maryland man was sentenced to nine years in prison for helping launder fraud proceeds tied to EIDL loans, shell companies, stolen identity documents, and bank accounts opened under false information.

  • 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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