Texas Medicaid Fraud Overview

This posting provides an overview of the national and state dimensions of Medicaid fraud, as well as efforts to detect and eliminate these crimes. The piece will look closely at Medicaid fraud investigation and enforcement in Texas. While this writer was unable to obtain an estimate of the fiscal impact of Texas Medicaid fraud, national estimates of annual improper Medicaid payments from 2015 total $140 billion or a staggering 12 percent of all Medicaid spending. Texas Medicaid The Medicaid program, created in 1965 as part of President Lyndon Johnson’s Great Society, is jointly funded by the state and the federal government according to the federal medical assistance percentage (FMAP). Texas has a larger match than many states (2019: 58.19 percent federally funded), as the FMAP is based on per capita income in the state, which is relatively low. In 2016, Texas Medicaid cost the state $17 billion and the federal government $23 billion. Medicaid is administered by the Texas Health