Medicaid Fraud Unit Plays Key Role in Largest Health Care Fraud Takedown in U.S. History

 

Texas Attorney General, Ken Paxton

AUSTIN, TEXAS (News Release) - Attorney General Ken Paxton announced that his Medicaid Fraud Control Unit (“MFCU”) played a major role in the largest health care fraud enforcement action in American history, resulting in criminal charges against 30 defendants connected to more than a dozen fraudulent health care schemes in Texas. The schemes collectively accounted for more than $177 million in fraudulent billings, $1.7 million in illegal kickbacks, and the unlawful diversion of over 10 million opioid pills.

“In Texas, we fight fraud head-on and will not rest until every last corrupt actor is brought to justice,” said Attorney General Paxton. “Together with President Trump and dedicated people at the Department of Justice, we are dismantling criminal enterprises that steal from taxpayers and endanger lives. Medicaid fraudsters exploit our health care systems for personal gain and drain resources from the citizens who need them most.”

As a part of a broader national takedown, law enforcement agencies targeted criminals who exploited taxpayer-funded health care programs for personal profit, leading to communities being flooded with dangerous prescription opioids. Charges brought through MFCU investigations included conspiracy to commit health care fraud, unlawful distribution of controlled substances, and violations of federal anti-kickback statutes. More than 30 Task Force Officers and Special Assistant United States Attorneys General from Attorney General Paxton’s Medicaid Fraud Control Unit worked in close partnership with federal law enforcement and the U.S. Department of Justice to identify and dismantle these criminal enterprises.

Since 2020, the MFCU has recovered more than $1 billion in settlements, judgments, and restitution for Texas taxpayers. The MFCU receives 75 percent of its funding from the U.S. Department of Health and Human Services under a grant award totaling $22,792,664 for fiscal year 2024. The remaining 25 percent, totaling $7,597,553, is funded by the State of Texas. Over the last 5 years, the OAG’s MFCU has achieved an extraordinary return on investment of 2,889 percent for Texas taxpayers.