Texas Attorney General Ken Paxton launched investigations on April 7 into dozens of Medicaid providers in the state using data acquired through the Department of Government Efficiency (DOGE).
Home health providers, occupational therapy providers, and entities that may have committed fraud related to COVID-19 treatments will be targeted in the investigation, according to Paxton.
The attorney general said he “will not tolerate the abuse of taxpayer funded programs in Texas.”
“My office has already recovered over $1 billion from Medicaid fraud alone since 2020, and I will continue to pursue any fraudster who attempts to cheat Texans out of money by exploiting our health care system,” Paxton said in a statement.
DOGE started a public portal on Feb. 13 of the largest Medicaid dataset in U.S. Department of Health and Human Services history, billing it as a way for the public to help the team detect fraud.
The dataset contains aggregated, provider-level claims data for specific billing codes over time and can be accessed by anyone in the general public, according to the Department of Health and Human Services (HHS), which oversees Medicare and Medicaid programs.
Paxton has created a Healthcare Program Enforcement Division, which recently filed a number of cases against entities, including Children’s Health, Eli Lilly, Sanofi, and others.
The Texas probe follows a similar investigation that netted several arrests in California last week involving an estimated $60 million in hospice care fraud, authorities announced on April 2.
The Trump administration granted the DOGE team access to information at HHS for DOGE’s effort to reduce waste, fraud, and abuse across the federal government.
HHS gave access to data containing Medicare beneficiaries, providers, and health plans, according to court documents. It also contained patient names and other sensitive data.
An executive order signed March 20, 2025, allowed federal agencies to remove internal barriers and gain access to all unclassified agency records, data, software systems, and information technology systems, according to court records.
DOGE’s expanding access prompted national labor unions to sue the U.S. Department of Labor in federal court to block the release of information, but that was denied. The case is still pending. Judge John Bates of the U.S. District Court for the District of Columbia denied the union’s latest request for summary judgment on March 31.
Health Secretary Robert F. Kennedy Jr. in Washington on Feb. 26, 2025. (Andrew Harnik/Getty Images)
National Fraud Cases
The U.S. Department of Justice also announced on April 7 that civil and criminal cases were filed against companies that allegedly tried to bill taxpayer-funded programs for more than $500 million in fraudulent claims.
The cases are part of the Trump administration’s Task Force to Eliminate Fraud, overseen by Vice President JD Vance.
In one case, Paul Randall, 66, of Orange, California, pleaded guilty on April 6, along with pharmacist and pharmacy owner Kyrollos Mekail, 37, of Moreno Valley, and nurse practitioner Patricia Anderson, 58, of West Hills.
They are accused of exploiting Medi-Cal’s suspension of its requirement that health care providers get prior authorization before providing certain medications at the beginning of 2022, when the agency was transitioning to a new payment system.
Prosecutors say Randall and his co-schemers allegedly billed Medi-Cal tens of millions of dollars for dispensing high-reimbursement drugs. Randall is also accused of paying kickbacks to patients and of other crimes. He agreed to forfeit property, including bank account balances exceeding $17 million, three vehicles, seven real estate properties, and sports memorabilia.
The government has seized about $126.5 million in assets that Randall and his co-schemers accumulated, including $111 million in bank funds and securities, according to the DOJ.
Randall pleaded guilty to one count of wire fraud. He faces a maximum of 30 years in prison. Mekail and Anderson pleaded guilty to two counts of health care fraud in 2024 and await sentencing.
Acting Attorney General Todd Blanche also announced on April 7 the creation of a National Fraud Enforcement Division.
“Its core mission will be to zealously investigate and prosecute those who steal taxpayer dollars and rip off the American people,” Blanche said.
The new unit will include 93 additional prosecutors at U.S. attorneys’ offices across the country, along with experts in health care, tax, benefits, and corporate fraud, Blanche said.
