The White House has posted a “Fraud Ledger,” which it describes as “a public record of the fraud, waste, and corruption identified by the Trump Administration’s Task Force to Eliminate Fraud since January 2025. The Task Force, established by Executive Order in March, is chaired by Vice President Vance and includes representatives from 11 agencies administering federal benefit programs, including those operated jointly with states (think Medicaid).
The Ledger lists amounts of “fraud uncovered” (i.e., estimated fraud identified through data analysis), “fraud stopped” (i.e., dollars saved through administrative actions), and “fraud enforced” (i.e., dollars recovered) for each of nine agencies, including HHS. The figures for each agency were reported to the Task Force by that agency. The HHS figures—$96.4B, $46.2B, and $32.9B—are not broken down by Medicare, Medicaid, and other HHS programs. There’s no explanation of how HHS arrived at its figures.
The Ledger identifies the “ten highest-impact anti-fraud actions” of the Task Force since January 2025. These speak volumes about the reliability of Ledger’s numbers.
Number 1 on the list is “Medicaid Fraud Deferrals”—$2 billion from California and $500 million from Minnesota. These are the amounts of federal matching funds CMS is currently withholding from California and Minnesota while it determines whether the states’ claims are allowable. They are not the amounts of documented fraud against the California or Minnesota Medicaid programs, as the Ledger misleadingly implies.
As former state health secretaries from Indiana and North Carolina recently explained:
“Withholding Medicaid funding from states is not a fraud-fighting strategy. It is a blunt instrument. It does not identify a fraudulent provider. It does not prove a false claim. It does not strengthen service documentation, improve provider screening, modernize data systems to better detect fraud, or help investigators build cases. It simply disrupts the flow of dollars that pay for health care and that pay to prevent fraud.”
Number 2 on the list is “MFCU Oversight and Enforcement Surge”—the decertification of Medicaid Fraud Control Units in New York ($60 million per year) and Hawaii ($2 million per year), along with standing up a Medicaid “Fraud War Room” that according to the Ledger is “saving $200 million in its first 90 days.”
HHS-OIG has in fact decertified the New York and Hawaii MFCUs. The amounts in question are the amount of federal matching funds that those Units will no longer receive to enable them to investigate and prosecute fraud against Medicaid (as well as patient abuse and neglect). There’s no evidence that defunding these MFCUs will reduce the amount of fraud against these states’ Medicaid programs, and there is every reason to believe that it won’t.
As for the “Medicaid Fraud War Room,” CMS issued a press release on July 28 announcing that the War Room stopped “more than $203 million in potentially improper Medicaid payments in just under 90 days.” According to the press release, the $203 million consists of $160.7 million attributable to 42 Office of Inspector General Notices of Intent to Exclude providers from federal health care programs and $46.2 million attributable to 15 state enforcement actions against providers based on War Room referrals. The press release does not indicate how much of these “potentially improper payments” were made (or would have been made) based on documented fraudulent claims by providers. (Improper payments are not the same as payments due to fraud). In the context of the Ledger a reader could understandably think the entire $203 million represented payments due to fraud against Medicaid.
According to the Ledger, the Task Force’s top ten were “drawn from the White House’s August 2026 report.” On August 6 the White House issued a press release listing “some of the Task Force’s key actions and victories to date.” Eleven of these items are related to fraud against Medicaid. Four have to do with matching funds CMS has withheld from California and Minnesota, totaling $2.8 billion; as noted above, these amounts are not documented fraud. Five concern charges brought by DOJ and MFCUs totaling $676 million; the figures represent unproven allegations of fraud. Only two of the items describe actual convictions for fraud against Medicaid, which total $277 million.
Bottom line: the White House Fraud Ledger is at best unhelpful and, in the case of Medicaid, fundamentally misleading. Federal matching funds withheld from state Medicaid agencies and MFCUs, which do not reduce fraud against Medicaid, are conflated with allegations of fraud and actual convictions for fraud to gin up large numbers. To be clear, reducing fraud against Medicaid (or Medicare, or any other federal program) is critical to making those programs work. A dashboard with accurate, clearly sourced metrics on the performance of federal and state agencies in addressing fraud against the programs would make an important contribution. The White House Ledger misses the mark.