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At least 80 Native Americans in Montana victimized in health care scheme
Fraudsters exploited year-round enrollment and state loopholes to bill insurers $54.7 million for unneeded or inflated treatments, prompting clawbacks of $23.3 million, Montana officials said.
- On Tuesday, Montana State Auditor James Brown announced his office identified and recovered over $23.3 million from fraudulent Native American ACA enrollments, with federal approval for rescissions.
- Members of federally recognized tribes can enroll year-round, and fraudsters exploited this timing along with a loophole in Arizona's American Indian Health Program that allowed out-of-state billing, risks flagged by the Government Accountability Office.
- Fraudsters who visited reservations pressured people appearing unhoused to enroll by promising free rehab, transported victims to out-of-state treatment centers in California, and billed for inflated or nonexistent treatments, including one case over $900,000.
- Brown's office has contacted the FBI and the U.S. Attorney's Office, urging federal charges since the fraud occurred on tribal land, and warned other state insurance commissioners that some insurance companies could limit out-of-state coverage as fake enrollments raise premiums and shrink networks.
- His office identified 207 suspected fraudulent enrollments totaling potential claims of $54.7 million, echoing a 2023 Medicaid fraud case involving Native Americans in Montana and signaling broader Marketplace vulnerabilities, Auditor Brown said the scheme could shift insurance coverage for Montanans.
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Associated Press News+12 Reposted by 12 other sources
At least 80 Native Americans in Montana victimized in health care scheme
Montana State Auditor James Brown announced Tuesday that his office had identified and worked to remedy a health care fraud scheme that targeted Native Americans.
·United States
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Total News Sources15
Leaning Left5Leaning Right2Center5Last UpdatedBias Distribution42% Left, 42% Center
Bias Distribution
- 42% of the sources lean Left, 42% of the sources are Center
42% Center
L 42%
C 42%
R 16%
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