US Treasury flags $17.5 billion in suspected health care fraud activity

The US Treasury Department said on Thursday that financial institutions had reported about $17.5 billion in suspicious financial activity potentially linked to health care fraud, offering law enforcement a window into schemes that may be exploiting government and private insurance programmes.

The figure comes from an analysis by the Treasury’s Financial Crimes Enforcement Network (FinCEN), which reviewed 5,702 Bank Secrecy Act reports filed between March 1, 2025 and February 28, 2026.

Treasury Secretary Scott Bessent said the reports from banks and other financial institutions were providing law enforcement with information that could help identify people and businesses involved in suspected fraud.

“By identifying and reporting this suspicious activity, financial institutions have given law enforcement critical insight into the illicit actors who deliberately exploit US health care benefits programs,” Bessent said.

Where the suspected fraud was found

FinCEN said the activity covered Medicare, Medicaid and private health insurance, with potentially fraudulent payments often coming from more than one type of health care programme.

Medicare payments identified in the reports frequently came through Medicare Administrative Contractors, while Medicaid payments were generally linked to state-level administrators.

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Banks and other depository institutions accounted for most of the reporting. They filed about 89 per cent of the reports examined by FinCEN and represented nearly 87 per cent of the reported suspicious activity value.

The reports covered subjects across the US. Financial institutions identified people or entities in every state, as well as Puerto Rico, Guam and the US Virgin Islands.

Of roughly 13,000 addresses associated with subjects in the reports, only about 1.5 per cent were outside the US, FinCEN said.

Home health care businesses lead

Home health care businesses were the most frequently identified type of suspected fraudulent provider, accounting for 20 per cent of the reports in which a provider was identified.

Other categories included hospice companies, mental and behavioural health and addiction treatment providers, medical equipment suppliers and adult and child day care businesses.

FinCEN also found that suspected proceeds were used for a range of purposes after the money was received. Some of the funds went towards personal expenses and luxury purchases, while some were transferred overseas.

The agency said a small number of reports pointed to suspected health care fraud involving larger fraud rings or criminal networks. Some also indicated possible connections to foreign entities.