We’re being defrauded out of $1 million every single minute. It’s time to stop the bleeding

By Rep. Jodey Arrington & Rep. Blake Moore
September 1, 2026
AS SEEN IN THE WASHINGTON EXAMINER

In South Florida, there are 20 times as many durable medical equipment suppliers as McDonald’s franchises. Federal officials recently halted payments to 900 suspicious hospice providers in Los Angeles, more than all hospice operations in the state of Texas. In Columbus, Ohio, there were 94 home-health companies operating out of a single building, bilking Medicaid for tens of millions of dollars.

Medicare and Medicaid have become open cash registers for criminal enterprises. As we speak, taxpayers are being charged for equipment never delivered, services never performed, and treatments patients never needed.

According to the Government Accountability Office, the federal government may be losing upwards of $500 billion a year to fraud. That’s nearly two months of mortgage payments for every American household and roughly the state budgets of California and Texas combined.

It’s $1 million, every minute of every hour, of every day, for an entire year.

This is organized, systematic theft, and it is happening on an industrial scale.

That is why we introduced the Anti-Fraud Fund Act, which will empower the most comprehensive and aggressive healthcare fraud prevention and enforcement campaign in history.

The bill marks a clean break from Washington’s failed “pay and chase” model. Under that model, the government pays a claim and investigates it later. Only after the fraud is discovered do investigators attempt to find the criminals and recover the money. Centers for Medicare & Medicaid Services officials say that this current fraud control system only recovers about ten cents of every dollar it chases.

Our plan establishes a prevention-first approach to tackling fraud. Dr. Mehmet Oz and his “fraud czar,” Kim Brandt, have already successfully used this method to return tens of billions of dollars otherwise stolen by criminals by identifying suspicious providers and flagging unusual billing patterns before taxpayer money ever leaves the treasury. These Medicaid Fraud War Rooms, which use data analysts to review fraud claims in real time, have saved $200 million in their first 90 days.

The return on investment for taxpayers is massive. Preliminary modeling from the nonpartisan Congressional Budget Office indicates this $28 billion investment would prevent or recover at least $196 billion over the next decade, leaving taxpayers at least $168 billion in tangible savings, a 7-to-1 net return on investment. Every dollar invested would prevent or recover at least seven dollars in fraudulent and improper payments. This is a commitment to fiscal discipline with concrete resourcing, something that has been sorely lacking for decades.

President Donald Trump’s Task Force to Eliminate Fraud has shown that this approach works. Last year, CMS’s program integrity efforts saved $42 billion in Medicare. That $42 billion is enough to cover three million knee replacements, seven million cataract removals, or 37.5 million routine colonoscopies for Medicare beneficiaries.

The administration’s recent nationwide healthcare fraud takedown resulted in charges against 455 defendants in schemes involving $6.5 billion. Yet CMS estimates Medicare and Medicaid still lose approximately $100 billion every year to waste, fraud, and abuse. Per Dr. Oz, returning that amount could double the life of the Medicare Hospital Insurance Trust Fund, which faces looming insolvency and automatic benefit cuts within the next decade.

We cannot keep up with fraudsters using yesterday’s tools. The fight starts with modern technology capable of analyzing claims in real time, identifying abnormal billing, and preventing suspicious payments.

It also means more boots on the ground: Investigators to follow the money, reviewers to scrutinize questionable claims, data analysts to connect the dots, and prosecutors to put fraudsters behind bars.

Finally, it means better coordination among federal agencies, law enforcement, and state officials. Criminals exploit the gaps between agencies, programs, and jurisdictions. Better information sharing will help close those gaps and ensure that no credible lead falls through the cracks.

We can do this without creating new bureaucracy, wrapping patients and honest providers in red tape, or expanding the government’s authority. We would not alter anyone’s eligibility or reduce a single legitimate benefit. This is all about adding more horsepower to go after criminals.

With our national debt approaching $40 trillion, this is what good fiscal stewardship looks like. We will come back to honoring our commitment to the people Medicare and Medicaid were created to serve. Every dollar stolen by a fraudster is a dollar unavailable to care for a senior, a child, or a person with a disability. Every criminal provider allowed to remain in the system undermines confidence in the honest doctors, nurses, and caregivers serving patients every day.

There can be no safe harbor for anyone who steals from American taxpayers, and no excuse for continuing to pay fraudulent claims when we have the tools to stop them. Congress must provide the resources to finish the fight.

House Budget Chairman Jodey Arrington is a member of the U.S. House of Representatives, serving Texas’s 19th Congressional District. Healthcare Task Force Chair Blake Moore is a member of the U.S. House of Representatives, serving Utah’s 1st Congressional District.