‘Statistical Illiteracy’ Rick Scott Demands AG James to Explain How NY’s Fraud Got Away

Chairman of the Special Senate Committee on Aging Sen. Rick Scott sent a letter to New York Attorney General Letitia James demanding answers on alleged rampant Medicare fraud in her state.

The Florida Republican’s letter noted that the number of indictments and convictions for Medicare fraud has declined under the New York Medicaid Fraud Control Unit (MFCU) since James assumed her role.

For instance, from 2023 through 2025, New York secured only 53 Medicaid fraud convictions, while the next-lowest state with a similar population secured 129 convictions, Scott’s letter said. In four of the past five years, New York recorded fewer than 10 criminal fraud indictments, ranking last among comparable states every year from 2021 through 2025.

In his letter, Scott added that the unit’s performance “fell off a cliff” in 2020, as fraud convictions decreased from 56 in 2019 to only 14 in 2020, and patient abuse and neglect convictions collapsed from 30 to just four over that same period.

“These figures are difficult to reconcile with the size and complexity of New York’s Medicaid program. A state serving millions of beneficiaries that generates so few prosecutable cases raises serious questions about the priorities and effectiveness of your office’s enforcement efforts,” Chairman Scott wrote, adding that the “timing of this collapse is hard to ignore.”

The Office of Inspector General at the U.S. Department of Health and Human Services decided to decertify the state’s fraud control unit and suspend future grant funding.

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First Assistant U.S. Attorney John A. Sarcone III stated in a July 2 release announcing the decertification that “based on its own reported statistics,” the fraud control unit “has failed to address public benefits crime in any meaningful way,” and had “averaged more than 100 indictments per year” before James’ time in office.

The Office of the New York State Attorney General did not reply to the Daily Signal’s request for comment by publication time.

The state’s Medicaid Fraud Control Unit has been ranked among the top of similarly sized units for patient abuse and neglect convictions since 2017; however, it has fallen in the rankings when compared with other states of similar size for at least five consecutive years since 2020, a year after James became state attorney general, Scott said.

“Most troubling is the drastic drop in patient abuse and neglect prosecutions, which directly affect elderly and disabled Medicaid beneficiaries,” Scott continued.

Scott noted in his letter that despite having received more than 2,000 abuse and neglect allegations each year, the unit was only able to obtain two or less convictions in each of the past three years.

“Those numbers strongly suggest that most allegations are either not being successfully investigated or are otherwise failing to result in criminal accountability,” Scott said in his letter.

Scott attributed the unit’s performance to “statistical illiteracy, not outperformance.”

“The poor return on investment for New York’s MFCU has been consistent, lagging behind the national MFCU average in five of the last six years,” Scott continued. “A state the size of New York, funded at $60 million per year in federal funds and maintaining a staff of more than 270 employees, should not be returning less than half the national average and then touting its presence in a press release as a ‘national leader in effectively investigating and prosecuting Medicaid fraud schemes.’”

How James Can Reinstate Certification

The senator is demanding that the attorney general explain why the fraud control unit should regain certification from HHS’s inspector general.

He requested the office provide copies of the corrective action plans it submitted to the inspector general, covering staff, referrals, case progression, and cooperation, in order to achieve full recertification before the Sept. 30, 2026, deadline.

Scott’s letter also states that James’ office must provide an explanation of why the unit’s 2015 strategic plan was allowed to persist for more than a decade without producing adequate criminal enforcement outcomes, as well as copies of the corrective action plans submitted to the inspector general covering staff, referrals, case progression, and cooperation to achieve full recertification before the Sept. 30, 2026, deadline.