A recent article in the New York Post has drawn attention to letters sent by Congressman Brett Guthrie (KY-02), Chairman of the House Committee on Energy and Commerce, along with Congressman John Joyce, M.D. (PA-13), Chairman of the Energy and Commerce Subcommittee on Oversight and Investigations, and Congressman Morgan Griffith (VA-09), Chairman of the Energy and Commerce Subcommittee on Health. The letters were addressed to governors and health agency leaders in ten states, seeking information about waste in state Medicaid systems and actions being taken to address it.
The investigation targets New York, California, Colorado, Massachusetts, Maine, Nebraska, Oregon, Pennsylvania, Vermont, and Washington State. The committee's inquiry follows reports of fraud or prosecutions in these states. In New York, two individuals connected to adult day care centers in Brooklyn and a home health care firm pleaded guilty earlier this year to defrauding Medicaid of $68 million. Another cited case involved $120 million allegedly stolen from Medicaid and Medicare funds by owners of Queens-based adult daycare centers and a pharmacy accused of taking kickbacks.
New York spent $115.6 billion on Medicaid for nearly 7 million people in fiscal year 2025. Governor Kathy Hochul’s budget plan noted that program costs have continued to rise at unsustainable levels.
Other letters sent to California, Colorado, Pennsylvania, and Nebraska highlighted significant increases in Medicaid spending over recent years.
“Fraud shouldn’t be a partisan issue,” said Energy and Commerce Chairman Brett Guthrie (R-Ky.). “It’s our most vulnerable Americans who are most at risk from fraudsters diverting precious resources intended for critical, needed care.”
“We owe it to our fellow Americans to preserve the Medicaid program for those that need it most, and states have an important role to play in ensuring that Medicaid programs operate with integrity,” he added. “The Committee will continue to combat rampant waste, fraud, and abuse across the entire country.”
The committee also referenced reports of fraud schemes in Minnesota that led federal authorities during the Trump administration to withhold more than $250 million in Medicaid funding due to issues such as overbilling, falsifying records, identity theft, and phantom claims targeting services for vulnerable populations.
“That fraud was perpetrated through ‘overbilling, falsifying records, identity theft, and phantom claims in Medicaid social service and health programs for the elderly and disabled, children with autism, people struggling with substance use disorders, and homelessness,’ wrote Guthrie and two other GOP subcommittee chairmen.”
Earlier this year the House Energy and Commerce Committee held a hearing featuring expert testimony about common types of Medicaid fraud schemes. These included high rates of abuse within Applied Behavioral Analysis (ABA) services for children with Autism Spectrum Disorder (ASD), substance abuse treatment centers, home- and community-based services among others.
Certified fraud examiner Jessica Gay told the committee that such programs should be closely monitored by every state: “If a state isn’t monitoring ABA services closely, they are likely missing a considerable area where FWA is committed,” Gay said.
“Medicaid fraud robs both taxpayers and patients, and we will pursue it wherever it hides,” Joyce said in a statement.
“Republicans in Congress will continue to do the necessary legwork to investigate allegations of waste, fraud and abuse within our Medicaid system,” added Griffith.
Governor Kathy Hochul responded by accusing the committee of "playing partisan games," but affirmed her commitment to pursuing bad actors within New York's Medicaid program. A spokesperson stated: “Congressional Republicans should learn from Governor Hochul’s dogged efforts to root out waste, fraud and abuse – including sweeping CDPAP reforms that shut down hundreds of wasteful Medicaid middlemen and saved over $2 billion for state and federal taxpayers while protecting home care for those who need it.”
A spokesperson for California Governor Gavin Newsom said: “California holds a strong commitment to protecting taxpayer dollars and the integrity of public programs like Medi-Cal. The state has taken action against Medi-Cal fraud for years and utilizes robust oversight mechanisms to protect the integrity of Medi-Cal programs and preserve public confidence.”
Colorado Governor Jared Polis’ office also issued a statement: “Colorado takes oversight of our Medicaid programs very seriously, prioritizes finding and rooting out fraud when it occurs—including referring cases to law enforcement.”
Representatives from seven other governors' offices or state health agencies did not immediately respond when asked for comment.
The House Energy and Commerce Committee is one of Congress’s oldest standing committees; its work covers energy policy as well as health care oversight among other areas according to its official website. Over time it has played roles influencing legislation on topics such as energy innovation or pharmaceutical pricing according to its website. Established originally as the Committee on Commerce and Manufactures in 1795 per official records, its responsibilities now include matters related not only to commerce but also environmental protection telecommunications consumer affairs as detailed online.
