Tag: fraud

MORE FRAUD: Colorado Made at Least $77.8 MILLION in Improper Autism Therapy Payments

A new federal audit has identified significant improper payments within Colorado’s Medicaid-funded autism therapy system, adding to a growing pattern of oversight failures in public healthcare spending. 

The findings, released by the Office of Inspector General, focus on Applied Behavior Analysis (ABA), one of the most widely used therapies for individuals diagnosed with autism spectrum disorder.

ABA therapy is designed to improve communication, social interaction, and behavioral functioning, and it has become a central component of autism treatment nationwide. 

As demand has increased, so has government spending. In Colorado, fee-for-service Medicaid payments for ABA rose sharply from $60.1 million in 2019 to $163.5 million in 2023. That rapid expansion, however, has not been matched by adequate oversight.

The audit examined Medicaid payments made in 2022 and 2023 and found systemic noncompliance with federal and state requirements. 

Every single one of the 100 sampled enrollee-months reviewed included at least one claim that was either improper or likely improper. That finding alone signals a structural issue rather than isolated billing errors.

Improper payments in this context do not necessarily mean intentional fraud in every instance, but they do indicate that providers billed for services that were not properly documented, not eligible under program rules, or not supported by sufficient clinical justification. 

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Trump Admin Busts Open Gavin Newsom’s $146 BILLION Medi-cal FRAUD Machine

Fox News just laid bare the staggering scale of waste, fraud, and abuse plaguing California’s Medi-Cal program under Governor Gavin Newsom.

In a hard-hitting segment, Kayleigh McEnany highlighted the eye-watering numbers: $146 billion per year lost to fraud in the state’s Medicaid expansion.

“That is slightly more than Warren Buffett’s estimated net worth. It is more than the GDP of several small countries,” McEnany stated.

The revelation comes as the Trump administration ramps up its nationwide assault on entitlement fraud through the White House Anti-Fraud Task Force and aggressive oversight by Centers for Medicare and Medicaid Services (CMS) Administrator Dr. Mehmet Oz.

Oz didn’t hold back when asked about the bigger picture.

“How big do you think this fraud is nationwide?” McEnany pressed.

“We believe nationwide it’s $100 billion in Medicare and Medicaid,” Oz replied. “If you’re worried about Medicare being there for you… and you’re worried that it’s going to expire… This fraud, getting rid of it, will DOUBLE the life expectancy of the Medicare trust fund.”

He added, “That’s a massive increase in numbers of years of extra Americans can trust that the program will be there for them.”

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Minnesota Judge Hands Somali Fraudster Just 6 Months After $500K Theft in Child Food Scam

A fraudster in the massive “Feeding Our Future” scandal has received just six months in jail after stealing nearly half a million dollars in taxpayer money meant for children.

Zamzam Jama was sentenced to six months behind bars and ordered to repay $491,000 for her role in the scheme.

The sentence was handed down by U.S. District Judge Nancy Brasel, who was somehow appointed by President Trump back in 2018, one day after a co-conspirator received only a one-year term.

Brasel has previously ruled in favor of mail-in voting and counting ballots days or even weeks after an election has concluded. Mail-in ballots are the most common method that Democrats use to cheat.

The case involves one of the largest fraud operations in recent U.S. history.

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Forget Minnesota – The Amount Of Fraud Uncovered In California Is Staggering

California is a cash machine. The state collects some of the country’s highest income, business, and fuel taxes, and now spends more than $300 billion per year. And yet, everywhere you look, California seems to be falling apart.

The roads are crumbling. Mismanaged wildfires have turned neighborhoods into ash. Drug addiction and homelessness have metastasized, turning parts of Los Angeles and San Francisco into no-go zones. And the cost-of-living crisis is pricing middle-class taxpayers out of basic necessities like groceries and gas, even as the state spends billions on welfare programs that never seem to lift anyone out of poverty.

Californians are beginning to ask: Where is all this money going? On paper, it funds hospitals, universities, schools, prisons, infrastructure, and other public services. But beneath the surface, something else is happening that California Governor Gavin Newsom does not want you to see: massive, systematic, brazen fraud.

We conducted interviews with public officials, fraud experts, and political figures, and reviewed hundreds of pages of government reports, state audits, criminal indictments, and other public records on California fraud. From unemployment insurance and Medicaid to failed homeless initiatives and welfare programs, seemingly every state program has been compromised by criminals. The best estimates suggest that, on the governor’s watch, fraudsters, scammers, and organized crime rings have stolen at least $180 billion from taxpayers.

Welcome to Gavin Newsom’s empire of fraud.

Fourteen months after Newsom began his first term as governor of California, the Covid-19 pandemic swept the world. Roughly 2.7 million Californians eventually lost their jobs. The state’s economy went into freefall as its leaders imposed some of the country’s most restrictive public-health measures. In response to the crisis, Newsom sought to dump pallets of cash across the state—as quickly as possible.

One way to inject money was through California’s massive unemployment insurance program (UI). Unemployment insurance is administered by the state’s Employment Development Department (EDD), which can process billions of dollars in payments monthly. Before the state turned on the cash machine, however, experts had warned that the system was ripe for fraud.

Haywood Talcove, one of America’s leading fraud specialists and CEO of LexisNexis Risk Solutions for Government, was one such expert. “I was begging [federal officials] not to let the money go out like that, because it was going to be the biggest fraud in the history of our country,” he said. “Obviously, I wasn’t successful.”

For many reasons, California was particularly susceptible to the large-scale fraud schemes Haywood Talcove saw on the horizon. Not only did the state have some of the most generous welfare programs in the country; its bureaucrats had also failed to implement some basic fraud controls during Newsom’s tenure.

“They literally suspended all of the rules for the [unemployment insurance] program,” Talcove said. “[That made] it possible for anyone to get that benefit even if they weren’t entitled to it. It was very intentional. They knew what they were doing. But it caught up to them because it just got so out of control.”

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One of the California Hospices Targeted in Fraud Sting Had a Survival Rate of 97 Percent

One of the hospices targeted in ‘Operation Never Say Die’ today had a survival rate of nearly 100 percent. It’s amazing that these people got away with this for as long as they did.

People check into hospices to die. It’s extremely rare that someone leaves on their feet. At this place, 97 percent of the patients lived. That is a statistical impossibility.

Just imagine how much more of this there is out there.

CBS News reports:

Hospice with 97% survival rate accused of defrauding Medicare for $7.45M

The FBI arrested a married couple Thursday accused of fraudulently billing Medicare for $7.45 million while running a hospice with a survival rate reported to be more than 97% after five years. They were the first in a series of arrests planned Thursday, federal officials told CBS News.

A high survival rate at a hospice provider is one of a series of red flags identified by state auditors for fraud because most people enter hospice care in the final stages of a terminal illness. In past cases of fraud, operators were found to be using false or stolen identities to collect federal reimbursements for palliative care.

The targets of the early morning operation were Gladwin and Amelou Gill, a doctor and psychologist who co-own 626 Hospice, which does business as St. Francis Palliative Care, according to the FBI.

The FBI raid took place in the residential neighborhood of San Dimas, California, as FBI SWAT personnel announced over a loud speaker they have an arrest warrant. CBS News was at the Southern California location when the FBI agents executed the first early morning arrests. Also on the scene was Dr. Mehmet Oz, the Trump-appointed official who oversees the federal Medicare system.

The Justice Department later announced that eight people, including the Gills, had been arrested and federally charged in connection with a health care and hospice fraud investigation.

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Woke San Francisco nonprofit boss charged with fraud made local library buy 1,500 copies of HER children’s book, netting her $100,000

A former California civil rights leader is accused of pocketing $100,000 by directing a library to buy thousands of her children’s books, amid allegations she siphoned funds meant for the black community. 

Sheryl Davis, former director of San Francisco’s Human Rights Commission, was arrested Monday on allegations of a ‘pervasive pattern of self-dealing,’ with prosecutors accusing her of misappropriating thousands of dollars in taxpayer funds. 

She allegedly used her partner’s nonprofit as a ‘slush fund’ for lavish personal spending, including travel, VIP party tickets and even her son’s tuition at UCLA. 

On Tuesday, an affidavit revealed that thousands of dollars were personally used toward promoting her children’s book through questionable deals and high-profile, celebrity-studded events, according to The New York Post.

The once-respected activist allegedly arranged the sale of 1,500 copies of ‘Free to Sing’ to the San Francisco Public Library, her book about a young black girl’s passion for singing despite criticism.

Davis raked in $100,000 in 2024 from book sales through her publisher, Book Baby, under the deal, according to an economic disclosure filing.

From 2021 to 2024, the nonprofit spent upwards of $30,000 on hotels and singer Goapele’s performances at two events, including $5,000 for a 2023 book launch party for Davis. 

The city’s Human Rights Commission (HRC) also spent at least $6,000 on the firm Varner PR, along with other expenses, to further promote sales. 

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Liberals Won’t Confront Fraud Because They Still Believe Government Is The Solution

At least the bombs are real.

New York Times columnist Nicholas Kristof has pulled out the hoariest of boomer liberal tropes, asking what the money spent on war could buy if redirected to welfare programs. Examples include “For less than three weeks of war, or $35 billion, we could run a nationwide pre-K program for 3- and 4-year-olds,” and “For $75 million, about an hour’s worth of war, we could provide three books free to every child in America who is living under the poverty line.” Ah yes, we could fund so many Minneapolis daycares and “Quality Learing” centers.

I don’t know how our campaign against the mullahs will turn out, but it has real bombs being dropped on real targets with people really dying. In contrast, the sorts of programs Kristof promotes as better recipients of taxpayer money tend to be more ephemeral in their results — and that’s assuming that the recipients even exist. To cite a few examples that even a New York Times columnist ought to have heard of, there is the Somali daycare piracy, the California wildlife bridge to nowhere, the California high-speed rail debacle, and the embarrassing spectacle of cities spending endlessly to end homelessness while not even reducing it.

Kristof and his ilk never seem outraged at these wasted and stolen billions. They might mildly tsk-tsk, but there is no visceral rage toward those who plunder billions that were supposedly for helping children. Yet if lefties really believe that government programs are the key to a wonderfully better society and world, shouldn’t they be furious at those running them into the ground or robbing them?

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Boston BLM Fraudster and “Bostonian of the Year” Must Return $220K in Funds Stolen Through Fraud

The Gateway Pundit reported that Monica Cannon-Grant, 44, a Boston-based Black Lives Matter activist who stole more than $100,000 in COVID funds and other financial resources to fund her lavish lifestyle, was sentenced to ZERO jail time.

Instead, she got six months of home confinement, followed by four years of probation.

Cannon-Grant is the founder and former Chief Executive Officer of a Boston-based nonprofit who was sentenced in January in federal court in Boston for using thousands of dollars in donations to Violence in Boston (VIB) to pay for personal expenses; defrauding the City of Boston out of COVID-19 relief funds and rental assistance money; defrauding the Suffolk County District Attorney’s Office out of Community Reinvestment Grant funds; filing false tax returns; and failing to file tax returns for two years.

Cannon-Grant was sentenced by U.S. District Court Judge Angel Kelley to four years’ probation, with six months of home detention and 100 hours of community service.

She was also ordered to pay restitution of $106,003 as well as forfeiture in an amount to be decided at a later date.

Now, a federal judge has ordered her to pay back an additional $224,063.

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Treasury Dept to reward fraud whistleblowers with up to 30% of fines

The Treasury Department launched a new program Monday to reward fraud whistleblowers with up to 30% of fines that are imposed on criminals.

“As promised, Treasury will reward whistleblowers who provide timely, actionable information on fraud, sanctions violations, and other significant illicit finance activity,” Treasury Secretary Scott Bessent said in a statement.

“President Trump has been clear that Americans have a right to know that their tax dollars are not being diverted to fund acts of global terror or to fund luxury cars for fraudsters. At Treasury, we follow the money, and we strongly encourage individuals to come forward with credible tips to help safeguard our financial system.”

The Treasury Department’s Financial Crimes Enforcement Network submitted a proposed rule to the Federal Register on Monday for the whistleblower payment program.

The program includes tipsters of Medicaid and Medicare fraud, according to The New York Post.

The launch comes after Bessent visited Minnesota in January, which is where Somali immigrants allegedly defrauded government welfare programs of at least $9 billion since 2018.

The reward payments will be directly from the fines, meaning that no taxpayer money will be used, according to confidential Treasury documents that the Post obtained.

“Individuals located in the United States or abroad who provide information may be eligible for awards if the information they provide leads to a successful enforcement action that results in monetary penalties exceeding $1,000,000,” one of the documents reads.

The Internal Revenue Service runs a similar program.

The program comes after Vice President JD Vance on Friday held the first meeting of a new anti-fraud task force that he is leading.

FinCEN also issued an advisory on Monday, warning financial institutions about fraud schemes targeting government programs such as Medicare and Medicaid.

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Vance Says Tim Walz Could be Prosecuted in Fraud Probe, Signals California Voter Fraud Will Also be Investigated

Vice President JD Vance discussed his plans with the Task Force to Eliminate Fraud in an interview with Benny Johnson on Friday, where he said that Tim Walz and other Democratic officials could “absolutely” be prosecuted for defrauding taxpayers. 

Chaired by Vice President JD Vance, with Federal Trade Commission Chairman Andrew Ferguson as Vice Chairman, “the Task Force will coordinate measures to improve eligibility verification, implement pre-payment controls, detect high-risk fraud trends, and disrupt and dismantle fraud networks and the mechanisms through which fraud is committed,” according to the order.

Earlier in the interview, Vance stated that Somali Rep. Ilhan Omar (D-MN)  “definitely committed immigration fraud, against the United States of America” and that the task force is looking into what can be done about it, The Gateway Pundit reported. ‘We’re trying to look at what the remedies are. That’s the thing we’re trying to figure out is what are the legal remedies now that we know that she’s committed immigration fraud? How do you investigate her? How do you go after her?” he added, suggesting that she may also be involved in the mass welfare fraud in the Somali community.

When asked about failed Vice Presidential candidate Tim Walz, Vance trolled Walz’s horrendous debate performance against him, then said, “We’re going to have to maybe kick him again a little bit.”

“We’re absolutely going to prosecute it,” he said if the investigation shows that Walz engaged in criminal activity.

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