Follow the money.
$1.09 trillion in
Medicaid spending.
We analyzed every Medicaid billing record released by HHS — and ran code-specific fraud detection across 617,000+ providers. 1860 providers raised red flags.
Total Spending
$1.09T
2018–2024
Billing Records
227.1M
Individual claims
Providers Analyzed
618K
Unique NPIs
Flagged Providers
1860
statistical + ML analysis
Procedure Codes
11K
HCPCS codes
Key Findings
1860
Providers Flagged
Using 13 statistical tests, 5 advanced detection methods, and machine learning trained on 514 confirmed fraud cases. None appear on the OIG exclusion list.
View watchlist$122.7B
Personal Care Spending
Code T1019 alone accounts for 11% of all Medicaid spending. The OIG calls personal care the #1 fraud-risk category.
See details0 of 1860
On OIG Exclusion List
Cross-referenced against 82,715 excluded providers. Zero matches — suggesting our analysis surfaces new, uninvestigated activity.
Our methodologyFeatured Investigation
6,886%
Community Assistance Resources & Extended Services INC grew from $1.6M to $112.6M in one year
A 6,886% spending increase in a single year while billing 4.5× the median rate for skills training services. Flagged by 7 of our 13 statistical fraud tests.
Spending Growth
Medicaid spending grew $76.32B from 2018 to 2024
-6.9% YoY
Highest-Spending Providers
Public Partnerships LLC
Supports Brokerage · Latham, NY
$7.18B
89.8M claims
Los Angeles County Department of Mental Health
Clinic/Center, Mental Health (Including Community Mental Health Center) · Los Angeles, CA
$6.78B
30.9M claims
Tempus Unlimited, Inc.
Voluntary or Charitable · Stoughton, MA
$5.57B
63.5M claims
Modivcare Solutions, LLC
Transportation Broker · Denver, CO
$3.09B
107.7M claims
Freedom Care LLC
Home Health · New Hyde Park, NY
$3.03B
22.0M claims
Top States by Provider Spending
Latest Insights
How We Did This
We analyzed 227 million Medicaid billing records released by HHS, covering 617,503 providers and 10,881 procedure codes from 2018–2024. We combined 13 statistical fraud tests — including 4 code-specific smart tests that compare each provider's cost per claim against the national median — with a random forest ML model (AUC: 0.77) trained on 514 OIG-excluded providers. These are unified into risk tiers (Critical, High, Elevated, ML Flag) for a single view of the most suspicious billing patterns.
1860
Red Flags in $1.09 Trillion
We analyzed every Medicaid provider in the country using 13 statistical tests and machine learning. See who got flagged.
View the Risk Watchlist