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Earlier this month, Attorney General Andrea Campbell says she's prepared to lodge yet another lawsuit against the federal government should the Trump administration's crackdown on Medicaid fraud in Minnesota shift focus to Massachusetts, where public benefits fraud is getting fresh attention.
Federal health officials last week paused $259.5 million in quarterly Medicaid matching funds in Minnesota to "prevent payment of questionable claims while further investigation is completed."
During a television interview earlier in the month, Campbell was asked whether a similar Medicaid funding freeze could unfold here. MassHealth, the state's Medicaid program, accounts for nearly one-third of the budget.
"Well, if they come for our resources, we will file suit like we have been," Campbell said on WCVB's "On the Record" program.
The AG said her office has filed nearly 50 lawsuits against the Trump administration in hopes of protecting more than $3 billion.
Demands for Accountability
Senate Republicans in Massachusetts recently called for an oversight hearing into public benefit fraud in the SNAP program. In their request to Senate Committee on Post Audit and Oversight Chairman Mark Montigny, the Senate GOP Caucus pointed to $34 million in public benefit fraud identified by Auditor Diana DiZoglio's office over a three-year period as well as two cases brought by U.S. Attorney Leah Foley.
In fiscal 2025 alone, the Bureau of Special Investigations within DiZoligo's office identified roughly $12 million in public benefit fraud. Nearly half of that figure was attributed to MassHealth.
DiZoglio's Medicaid Audit Unit has also released a report identifying nearly $8.5 million in potential cost savings at MassHealth, based on probes into dental services, transportation services, durable medical equipment (DME) providers and inpatient maternity services.
MassHealth paid about $521,500 for "DME that could not be verified as having been ordered by an eligible provider" and about $31,700 for DME ordered by providers who are excluded from MassHealth. The report said MassHealth also paid providers $27,400 for equipment ordered for deceased members.
MassHealth said it plans to investigate the report's claims and recoup overpayments, and the agency said it offers training for providers to comply with state and federal laws, according to the report.
"MassHealth emphasized that due to the delay in how it receives information about deceased members, it relies on the postpay process to recoup payments for its members who had passed away," the report continued
In recent days, State Auditor Diana DiZoglio released a Bureau of Special Investigations (BSI) report examining the periods of July 1, 2025 to September 30, 2025 and October 1, 2025 to December 31, 2025. The report summarizes BSI’s work and initiatives to help make government work better by investigating fraud, abuse, and illegal acts involving public assistance benefits throughout the Commonwealth.
During these periods, BSI investigated a total of 1,847 cases and there were overpayment calculations in 317 cases with identified fraud. Further details regarding these 317 cases may be found below.
Summary of Investigations Completed with Fraud Identified:
- Supplemental Nutrition Assistance Program (SNAP) $2,482,378
- MassHealth/Medicaid $1,717,084
- Transitional Aid to Families with Dependent Children (TAFDC) $144,664
- Personal Care Attendant (PCA) $88,962
- Emergency Aid to the Elderly, Disabled, and Children (EAEDC) $30,572
- Department of Early Education & Care (EEC) $22,442
Grand Total $4,486,102
“Fraud affects everyday Massachusetts residents who depend on these programs to obtain healthcare or put food on the table,” said Auditor DiZoglio. “This makes the work of our fraud examiners essential in ensuring programs operate efficiently, reliably, and as intended for those who truly need them.”
