Health and Life Organization, Inc.
New Entrant
Started billing recently but already receiving millions in Medicaid payments.
First appeared in 2022-05 and has already billed $38.2M, averaging $1.2M/month across 32 months.
Explosive Growth
Billing increased over 500% year-over-year — far beyond normal growth patterns.
Billing grew 831% from 2022 to 2023.
Statistical flags are not proof of wrongdoing. Some entities (government agencies, home care programs) may legitimately bill at high rates. Hospitals, government entities, and large care organizations may legitimately bill at higher rates due to patient acuity, overhead costs, or specialized services. Read our methodology.
Red Flags Explained
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Each flag represents a statistical test that identified unusual billing patterns. Here's what each flag on this provider means in plain English:
New Entrant
New Entrant means this provider began billing Medicaid recently but is already receiving millions of dollars in payments. While some new providers legitimately grow fast (e.g., large group practices), this pattern is also common in fraud schemes that set up shell companies to bill aggressively before shutting down.
Explosive Growth
Explosive Growth means this provider's billing increased by more than 500% year-over-year. While rapid expansion can be legitimate, this pattern has been observed in fraud schemes that ramp up billing quickly before detection.
These flags are statistical indicators only. Many flagged providers have legitimate explanations for their billing patterns. Learn more about our methodology.
Compared to Pediatrics Peers
Total spending distribution among 14 providers in this specialty
This provider's total spending of $38.2M is at the 25th percentile among 14 Pediatrics providers.
Total Paid
$38.2M
$38,175,148
Total Claims
358K
Beneficiaries
284K
1.3 claims/patient
Avg Cost/Claim
$107
🔍 Analysis
Provider Overview
Health and Life Organization, Inc. is a Pediatrics provider based in Sacramento, CA. From the 2018–2024 period, this provider received $38.2M in Medicaid payments across 358K claims.
Why This Matters
At $38.2M in Medicaid payments, this provider represents significant public healthcare spending. Understanding where these dollars go helps ensure the program serves those who need it most.
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