Attorney General Alan Wilson urges Congress to help states fight Medicaid fraud

(COLUMBIA, S.C.) –South Carolina Attorney General Alan Wilson and 16 other attorneys general have sent a letter to the House Committee on Energy and Commerce and the Senate Committee on Finance expressing their support for the swift passage of H.R. 5364 and S.4176. Both pieces of legislation are known as the “STOP FRAUD in Medicaid Act.”

"We have just begun to see the uncovering of massive fraud in multiple sectors across the United States," Attorney General Alan Wilson stated. "Medicaid fraud is robbing from some of our most vulnerable citizens. It's time for Congress to give every state the resources it needs to prosecute Medicaid recipient fraud."

Currently, federal restrictions on State Medicaid Fraud Control Units limit the States to investigating and prosecuting Medicaid provider fraud. The STOP Fraud in Medicaid Act seeks to expand the ability of States to investigate and prosecute Medicaid beneficiary/recipient fraud as well. South Carolina led the letter because it is one of the only states with a dedicated state-level Medicaid Recipient Fraud Unit that focuses on both investigation and prosecution of Medicaid Beneficiary Fraud.

The Medicaid program is a vital lifeline for millions of our nation’s most vulnerable citizens. To protect these individuals and the program’s integrity, the restriction of federal funding should be lifted to allow State Medicaid Fraud Control Units (MFCUs) to investigate and prosecute Medicaid recipient fraud.

The Department of Health and Human Services Office of Inspector General found that in 2025, MFCUs recovered $4.64 for every dollar spent by States and the Federal Government. For fiscal year 2025, almost $2 billion was recovered from criminal and civil cases combined. These MFCU convictions led to OIG exclusions of 900 individuals and entities from Federal health care programs.

These recoveries and convictions have been made even when most states do not have an MFCU division with federal funding to investigate and prosecute Medicaid recipient fraud. The passage of the STOP Fraud in Medicaid Act will allow our states to ensure citizens’ tax dollars are being stewarded wisely and not stolen.

The following states joined South Carolina in this letter: Alaska, Arkansas, Florida, Idaho, Indiana, Kansas, Kentucky, Louisiana, Mississippi, Missouri, Nebraska, New Hampshire, North Dakota, Oklahoma, South Dakota, and West Virginia.

You can read the letter here.

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