Feb 14, 2026 · 3:52 AM UTC
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Great article... you should do this for every state because I bet it's happening everywhere but especially in blue states which are all poorly run and the Democrats practically support and enable fraud like this
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In the reading below, Luke has four kids. I don't know how old they are, but the thought of him crunching the data, surrounded by chaos, puts a big smile on my face.
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Great job! Considering you were able to do this in less than 2 days, it is clear we need to do more house cleaning in government agencies. They are clearly useless for their function. This should be one of their principal tasks.
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Great summary. Just shipped MedicaidData API, an open analytics layer on top of the HHS Medicaid Provider Spending dataset. Full REST API with provider search, billing histories, and CSV exports.
medicaid-data-api.replit.app
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Let a former Medicaid analyst say get a suggestion. Don’t focus on billed amounts; use paid amounts. Also look at the growth in billed units. That’s where this stands out. Great job and hopefully we can get this fraud conquered.
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If these are billed amounts then it’s noise. If these are paid amounts then the delta is in the # of units per date of service. And the real juicy part lies with some bureaucrat who left out a cell on a csv creating a loophole for T1019 - no ‘allowable’ now paid at full charge
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Great work. A good oversight and fraud detection unit should use your data as a starting point regarding where to look.
The next part should be marrying tax documents (# of employees, expenses, salaries, etc.) to those specific companies. Any business doing a volume greater than 100K/month is going to need more than one employee.
Other things of concern:
Lifestyle to income ratio for the business: Why are some of these businesses operating out of apartments when they make over 100K/month? Does Maine have the largest group of Healthcare providers who prefer humble lifestyles?
Notoriety: If these businesses don't advertise or have pubic level awareness then how are their customers finding them? Are they on a designated list of potential in-home providers that is widely circulated in the medical community? If not, they have the best word-of-mouth advertising system ever.
Again...GREAT WORK!
Keep shining light in those dark places. It's time to make the critters run for cover.
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