Attorney general recovers $100 million in Medicaid fraud since 2021

INDIANAPOLIS (WISH) — Attorney General Todd Rokita on Tuesday said overbilling and drug diversion top the causes of Medicaid provider fraud in Indiana.

Rokita said his office has now recovered more than $100 million in Medicaid provider fraud since he took office in 2021, with the bulk of that money already returned to the state’s Medicaid program. He said there have been 233 convictions as a result, as well as 292 exclusions from future Medicaid billing. He said the causes of provider fraud vary but often involve individual doctors or nurses overbilling patients or reselling pharmaceuticals above market price.

Rokita and his Medicaid fraud recovery director, Matthew Whitmire, said although $100 million doesn’t sound like much compared to the total size of Medicaid, which costs tens of billions of dollars per year, but the key is the deterrent effect.

“Providers see that they’re being held accountable for overbilling, for split billing, for billing for services not rendered. It gives them pause when they see their colleagues held responsible for this and have to pay back those funds and perhaps go to prison and be excluded from the program,” Whitmire said. “The $100 million represents a deterrent to further fraud by other people, other providers in the system.”

Rokita said his office does not have the authority to investigate potential fraud by Medicaid recipients. He said that’s up ...