Where can one find state-by-state Medicare fraud recoveries data for 2024 and 2025?
Executive summary
Federal and state reporting on health‑care recoveries is fragmented: the most reliable state‑level recovery figures in the public record for fiscal 2024 come from the HHS Office of Inspector General’s (OIG) reporting on state Medicaid Fraud Control Units (MFCUs), while consolidated, state‑by‑state Medicare fraud recovery tallies for 2024–2025 are not published in a single federal dataset in the documents provided [1] [2] [3]. To assemble state‑by‑state Medicare figures, reporters must combine multiple sources—OIG MFCU annual data for Medicaid (state‑focused), HHS‑OIG semiannual reports and CMS improper‑payments products for program‑level Medicare estimates, and DOJ/state prosecutor releases for case‑level recoveries [1] [4] [3] [5].
1. Where the clearest state‑level recoveries live: HHS OIG’s MFCU reports (Medicaid, FY2024)
The most granular state‑by‑state recoveries currently public and systematically collected are the annual statistical submissions from 53 state MFCUs to HHS OIG, which the OIG analyzed and published as its FY2024 MFCU data snapshot and annual report; those documents break out convictions, civil settlements and recoveries by unit (effectively state) for FY2024 [1] [2]. Commercial legal summaries and health‑law outlets draw on that OIG dataset to report that MFCUs collectively recovered $1.4 billion in FY2024 — a figure repeatedly cited in industry coverage — and those MFCU reports remain the authoritative starting point for state‑level Medicaid recovery data [6] [7] [8].
2. Why that MFCU data is not the same as “Medicare” state recoveries
MFCUs investigate state Medicaid fraud and beneficiary abuse; their annual statistical reports are therefore a Medicaid, not Medicare, dataset, and should not be used as a direct proxy for Medicare recoveries without caveats [1] [2]. CMS’s fiscal‑year improper‑payments products cover Medicare program‑level improper payment rates and dollar estimates (e.g., Medicare FFS improper‑payment rate and Part D estimates) but do not provide a neat state‑by‑state breakdown of fraud recoveries in the documents supplied [3]. The result: state‑level Medicaid recoveries are accessible via OIG MFCU reporting, but an equivalent consolidated state‑by‑state Medicare fraud recoveries table is not present in these federal publications [1] [3].
3. Where to look for Medicare fraud recoveries by state: a pragmatic playbook
To compile state‑by‑state Medicare fraud recoveries for 2024–2025, use a multi‑source approach: pull HHS‑OIG semiannual reports and audit releases for expected recoveries and receivables (which summarize billions tied to OIG investigations) and extract any jurisdictional tagging available [4]; query CMS improper‑payments fact sheets for national program totals and methodological context about what is counted as improper versus fraudulent payments [3]; and mine DOJ press releases and state U.S. Attorney or Attorney General announcements for case‑level recoveries and forfeitures, which often identify the state where charges or recoveries occurred [4] [5]. Industry reports and law‑firm summaries can help aggregate and interpret these items but rely on the underlying federal and state documents [6] [7].
4. Limits, caveats and alternative framings in available reporting
The documents reviewed show major recoveries and case wins but also expose methodological limits: OIG semiannual and CMS improper‑payments reports combine recoveries, expected receivables and improper‑payment estimates that are not strictly prosecutorial “fraud recoveries,” and MFCU data focuses on Medicaid, not Medicare, leaving a gap for a one‑stop, state‑by‑state Medicare fraud recoveries table in the public sources provided [4] [3] [1]. Reporters should therefore label any compiled state figures carefully—distinguishing Medicaid MFCU recoveries, CMS improper‑payment estimates, and DOJ/state enforcement recoveries—and should expect to supplement federal data with state prosecutor press releases for the jurisdictional detail often omitted from national summaries [2] [5].