New York ranks near bottom in Medicaid fraud prosecutions per spending

An analysis by the Empire Center for Public Policy ranked New York 49th among states for criminal Medicaid fraud investigations per billion dollars spent during the period from 2019 to 2025. The state placed 51st for indictments per billion dollars and 51st for convictions per billion dollars.

The Empire Center fellow said the rankings reflect federal data on the state’s Medicaid Fraud Control Unit performance. New York spent $124 billion on Medicaid in fiscal year 2024, the highest per-resident amount among the 50 states and 77 percent above the national average.

Federal funding decision The U.S.

Department of Health and Human Services Inspector General notified the state in a June 30 letter that $60 million in federal funding for the Medicaid Fraud Control Unit would be suspended through at least Sept. 30. The letter cited insufficient criminal indictments and convictions.

A spokesperson for the attorney general’s office disputed the assessment and said New York recovered more than $627 million in Medicaid funds since 2019, ranking among the top 10 states for recoveries each year.

Spending and recovery comparisons The Empire Center analysis found that New York’s civil recoveries as a percentage of spending ranked 16th for the full term and its criminal recoveries ranked 49th. Investigations of all types fell 50 percent in the state from 2020 to 2025, compared with a 19 percent national decline.

The Republican candidate for attorney general said she would add 20 criminal prosecutors and recover at least $1 billion in stolen funds during a first term if elected. The attorney general’s office said 69 of 115 criminal convictions from 2020 to 2025 involved owners, executives, or corporations returning large amounts to the program.