Is Minnesota’s Medicaid fraud scandal an ‘outlier?’ Experts say the answer is complicated.

The federal prosecutor who formerly helmed the effort to root out wrongdoing in Minnesota welfare programs has called the state “the leader in fraud.”

Officials are investigating more than a dozen social services programs that federal prosecutors say could have lost some $9 billion to fraud since 2018. Fifteen people have been charged with defrauding housing and autism programs so far.

That number is likely to grow as fraud investigations continue. The Minnesota Star Tribune has tallied $217.7 million to date in fraud in programs by counting court records, criminal charges and convictions.

U.S. Attorney Joe Thompson, the lead prosecutor in the fraud case before resigning this month, has insisted the scale and style of wrongdoing in welfare programs make the state an “outlier.”

But is that true?

In short, it’s difficult to say for sure how Medicaid fraud in Minnesota stacks up against other states.

Every state shares annual data with the federal government showing Medicaid fraud investigations, indictments, convictions and recoveries, but experts say those figures don’t convey how much Medicaid fraud occurs in a state.

What’s more obvious from the data: Authorities have investigated fraud in every state. And, occasionally, they’ve uncovered schemes that share similarities with Minnesota’s sprawling scandal.

Other states have faced comparable scandals.

Take the New York adult day care provider who billed $68 million to Medicaid for services she didn’t offer. Or the dozens of Arizona health workers who targeted Native American people seeking addiction treatment while fleecing $2.5 billion from the state. One Georgia man alone pocketed $4.3 million in kickbacks by getting Medicaid recipients to take medically unnecessary genetic tests.

Gov. Tim Walz has called Thompson’s 10-figure sum speculation while pledging to clean up social services during his remaining months in office. President Donald Trump has lambasted the Democratic governor for allowing fraud to fester, citing the unproven claim that Somali providers stole “billions” from the state as a reason to deploy thousands of federal agents here.

Minnesota has spent a similar amount on Medicaid as Washington, Indiana, Virginia and Maryland over the past six years — roughly between $90 and $100 billion.

In 2024, 36 of 817 people across the country who were convicted of pilfering from federally funded programs committed their crimes in Minnesota, with authorities recovering over $16.5 million in criminal and civil cases, according to data from the U.S. Department of Health and Human Services.

Minnesota’s fraud-fighting staff, however, is smaller than that of nearly half of all states. Authorities have asked for more resources, though the state Legislature last year denied Attorney General Keith Ellison’s request for additional money to hire nine more staff members.

But looking beyond Minnesota’s borders — and the heated political moment — complicates the state’s current reputation as a hotbed of grift.

Minnesota has long attracted attention and immigrants for its bouquet of community-based programs, and experts say the simultaneous occurrence of possible fraud in 14 Medicaid-funded resources stands out.

But they point to data showing that some providers in other states have at times taken advantage of similar services, with schemes totaling millions and even billions in stolen funds. So, too, have they occasionally hewed to a playbook popular among unscrupulous providers in Minnesota — from billing for assistance never provided to preying on vulnerable people.

The state Department of Human Services declined requests for comment.

Newly released data on improper Medicaid payments offers another point of comparison. The Centers for Medicare & Medicaid Services (CMS) found Minnesota’s 2025 improper payment rate was just over 2%, or about $254 million. The national average was slightly above 6%.

But improper payments don’t necessarily indicate fraud. They include instances where someone was over- or underpaid, or missed an administrative step. The vast majority of improper payments last year were because of insufficient documentation, which, according to the federal government, generally doesn’t indicate fraud or abuse.

Andy Schneider, a Georgetown University professor who served as a senior advisor at the CMS during the Obama administration, noted that the largest number of fraud convictions reported across the U.S. in 2024 involved personal care assistants. Those individuals help people with daily tasks like bathing and dressing.

Personal care assistance is one of over a dozen Minnesota welfare programs to which the state froze payments last year as authorities investigate bad actors.

Thompson has consistently said misconduct in state Medicaid programs is more severe in Minnesota than in other places and claimed oversight has lagged.

Providers here, he said at a December news conference, have created “shell companies” to defraud programs wholesale rather than lean on traditional tactics like overbilling. Some, he added, have funneled money to East Africa and Kenya.

The Minnesota Star Tribune found scant evidence to corroborate a conservative publication’s assertion that fraudsters sent stolen taxpayer funds to a terrorist group based in Somalia. Thompson has also disputed that claim.

“What we see in Minnesota is not a handful of bad actors committing crimes; it’s staggering, industrial-scale fraud,” Thompson said. “It’s swamping Minnesota and calling into question everything we know about our state.”

Thurber said Minnesota’s scandal stands out because alleged fraud is concentrated in community-based services. People are less familiar with the grab bag of programs that offer everything from autism treatment to housing support than hospitals or private practices. They also have less experience regulating them, he said.

The state’s response to the unfurling scandal — freezing enrollment in a suite of programs that authorities have flagged as potentially fraud-ridden — has also struck some observers as unique and some legitimate providers as overly punitive.

But the politicized microscope trained on Minnesota has made determining the singularity of the state’s fraud problem much blurrier.

“I think that the current climate has put an emphasis on fraud in particular states,” said Karen Weintraub, an executive at Healthcare Fraud Shield, a firm that helps insurance companies detect wrongdoing. “I’m sure that’s driving some of the attention that it’s getting.”