U.S. Senate Aging Committee Chairman Rick Scott has sent a letter demanding answers from New York Attorney General Letitia James following the decertification of the state’s Medicaid Fraud Control Unit by federal authorities.
In the letter released today, Scott pointed to sharp drops in state criminal convictions and patient abuse prosecutions, citing findings from the U.S. Department of Health and Human Services Office of Inspector General (OIG).
The federal watchdog recently moved to decertify New York’s unit and suspend future grant funding.
According to federal data cited by Scott, New York secured 53 Medicaid fraud convictions between 2023 and 2025, compared to 129 in the next-lowest comparable state. The unit also recorded four convictions for patient abuse and neglect over that three-year period, despite receiving more than 2,000 allegations annually.
The decline began shortly after James took office in January 2019, Scott noted in his letter. State fraud convictions dropped from 56 in 2019 to 14 in 2020, while patient abuse and neglect convictions fell from 30 to four during the same period.
“New York’s Medicaid beneficiaries, many of whom are seniors who cannot advocate for themselves, deserve an Attorney General that treats their safety as seriously as it treats high-profile civil litigation,” Scott wrote.
The OIG review attributed the decline in criminal enforcement to a deliberate organizational shift dating back to a 2015 strategic plan, which prioritized complex civil litigation over criminal fraud and abuse cases. Federal auditors also found that the unit failed to reliably track case referrals sent to other prosecuting agencies, potentially allowing individuals convicted of patient abuse to remain eligible for Medicare and Medicaid programs.
Financially, the New York unit operates with an annual federal budget of $60 million and a staff of more than 270 employees. In 2025, the unit returned $1.84 for every taxpayer dollar spent, compared to a national average return of $4.64 among state Medicaid fraud units.
Scott’s letter asks James’ office to provide the committee with copies of corrective action plans submitted to the OIG ahead of a Sept. 30, 2026 recertification deadline. He also requested an explanation for the prolonged reliance on the 2015 strategic plan and a full accounting of tracking failures regarding convicted healthcare providers.
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