Hawaii disputes Vance criticism on Medicaid fraud

Summary

Hawaii’s attorney general said the state pursued Medicaid fraud cases despite no indictments or convictions in the past four fiscal years.

Why this matters

The dispute highlights federal scrutiny of state Medicaid fraud enforcement and the potential risk to federal funding that supports Hawaii’s fraud unit. It also provides context on how Hawaii measures enforcement results beyond indictments and convictions.

Hawaii Attorney General Anne Lopez said Thursday that the state has not failed to pursue Medicaid fraud, responding to Vice President JD Vance’s criticism a day earlier.

Vance, who chairs an anti-fraud task force created by President Donald Trump in March, said Wednesday at a White House news conference that Hawaii’s Medicaid Fraud Control Unit had no fraud indictments or convictions in recent years because state administrators were not treating the issue seriously.

“They don’t think that fraud is a big enough problem,” Vance said. “They don’t care about protecting resources, and they don’t care about protecting that Medicaid program.”

Lopez’s department did not dispute federal records showing Hawaii’s unit had zero Medicaid fraud indictments and zero convictions in each of the past four fiscal years. But it said that record does not reflect the full scope of the unit’s work.

The department also said the unit settled a Medicaid fraud case earlier this year for $208,318, and separately filed criminal charges against two people in a case involving the endangerment of an incompetent person. One of those defendants has pleaded no contest.

Vance said letters were sent Wednesday to every state Medicaid Fraud Control Unit asking them to show they are aggressively and effectively prosecuting Medicaid fraud. He said states could lose federal funding, which accounts for 75% of those units’ budgets, if they do not.

Lopez’s office said a team from the U.S. Department of Health and Human Services Office of Inspector General reviewed Hawaii’s unit on-site in April, interviewed staff, and identified challenges in initiating criminal charges and obtaining convictions.

About 387,000 Hawaii residents are enrolled in Medicaid through Med-QUEST, a program that cost $3.2 billion last year, mostly paid with federal funds. Hawaii’s Medicaid Fraud Control Unit has a $3.9 million budget this fiscal year, with $976,489 provided by the state to support a staff of 15.

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