At least $9B billed across 14 Medicaid services in Minnesota may be fraudulent, top prosecutor says

Federal prosecutors have charged five individuals in connection with what they describe as "staggering, industrial-scale" Medicaid fraud in Minnesota, with at least $9 billion in potentially fraudulent claims across 14 Medicaid services. The defendants include Anthony Waddel Jefferson and Lester Brown, two Philadelphia residents accused of "fraud tourism" who registered as Minnesota providers while living out of state and siphoned millions from federally funded programs meant to help the disabled and those suffering from addiction. One defendant submitted $1.4 million in fraudulent claims and allegedly fled the country after receiving a subpoena, using some funds to purchase cryptocurrency.

The investigation, led by the U.S. Attorney for the District of Minnesota, has resulted in charges against 13 individuals total, with some defendants previously charged in September for their roles in defrauding the Minnesota Housing Stability Services Program. Prosecutors also charged a new defendant accused of defrauding a state-run program providing services for children with autism. Federal officials have criticized Minnesota state oversight, with the U.S. Attorney stating that the state "has not done a good job of mining these programs," highlighting systemic vulnerabilities in program administration and fraud detection.