Missouri – Nearly $2 billion recovered in a single year has given state attorneys general a powerful argument: Medicaid fraud investigators work, but federal law is keeping them from following every lead.
Missouri Attorney General Catherine Hanaway and attorneys general from 16 other states are now asking Congress to remove that barrier by quickly approving legislation that would expand the authority of state Medicaid Fraud Control Units.
The coalition sent a letter to the U.S. House Committee on Energy and Commerce and the Senate Committee on Finance supporting H.R. 5364 and S. 4176. Together, the bills are known as the “STOP FRAUD in Medicaid Act.”
“The STOP FRAUD in Medicaid Act is an essential piece of legislation that will allow our state to further crack down on Medicaid fraud and prosecute those who prey on the vulnerable,” Hanaway said.
“Congress should act swiftly and pass this legislation so states can pursue those who want to exploit the system for personal gain.”
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Under current federal restrictions, state Medicaid Fraud Control Units generally investigate and prosecute fraud committed by health care providers. The proposed legislation would broaden that authority, allowing the units to pursue suspected fraud involving Medicaid beneficiaries and recipients as well.
Supporters point to federal data showing that the specialized units already return far more money than they cost. According to the U.S. Department of Health and Human Services Office of Inspector General, the units recovered $4.64 for every dollar spent by states and the federal government in 2025.
Criminal and civil cases produced almost $2 billion in recoveries during fiscal year 2025. Convictions secured by the units also led the inspector general’s office to exclude 900 people and organizations from participating in federal health care programs.
Missouri’s Medicaid Fraud Control Unit includes prosecutors, investigators and support personnel. It handles allegations of provider fraud while also prosecuting abuse, neglect and financial exploitation connected to Medicaid-funded facilities.
For federal fiscal year 2026, the unit is receiving $3,551,892 from the Department of Health and Human Services, covering 75 percent of its funding. Missouri is supplying the remaining 25 percent, or $1,183,960.
Joining Missouri in the congressional appeal were Alaska, Arkansas, Florida, Idaho, Indiana, Kansas, Kentucky, Louisiana, Mississippi, Nebraska, New Hampshire, North Dakota, Oklahoma, South Carolina, South Dakota and West Virginia.
The states’ request now places the decision before Congress: keep Medicaid fraud enforcement within its existing boundaries or give investigators broader power to pursue suspected exploitation wherever it occurs.
