Attorney General Pam Bondi celebrated a "historic deal" with Northwestern University on Nov. 28. (AP Photo/Mark Schiefelbein)
But before the Justice Department can chase down new leads, it may have to sort through mountains of flawed data.
Information shared by DOGE in its early days may be imperfect due to its reliance on state data submitted through the Transformed Medicaid Statistical Information System, or T-MSIS — a system that has struggled with data quality and reporting issues that vary widely from state to state. The Centers for Medicare & Medicaid Services is actively working to improve state compliance.
There are open questions as to how the federal government might seek to retroactively "claw back" Medicaid reimbursements from states, in the event fraud is detected.
Others have cautioned that investigations could be hindered by new or thorny legal challenges — including privacy concerns, statute of limitations questions and evidentiary hurdles.
The emphasis on healthcare fraud reflects a broader enforcement priority for Trump and Attorney General Pam Bondi, who built her prosecutorial profile in Florida cracking down on opioids, drug trafficking, and so-called "pill mills."
Attorney General Pam Bondi accompanied by Deputy Attorney General Todd Blanche and FBI Director Kash Pate, speaks during a news conference. (Andrew Harnik/Getty Images)
The new data analytics have been crucial to helping DOJ develop and prosecute widespread instances of healthcare fraud cases, as well as major prescription drug cases.
One official pointed to the recent conviction of a California telehealth company founder and CEO who was sentenced to 20 years in prison for illegally prescribing and distributing roughly 40 million Adderall pills, a Schedule II controlled substance, over the internet using false and fraudulent information.
The tools the Justice Department used in that case were critical in quickly identifying the $100 million scheme.
CLICK HERE TO GET THE FOX NEWS APP
The Justice Department’s Health Care Fraud Unit announced the largest-ever national healthcare fraud takedown in its history in 2025, securing an estimated $15 billion in losses and forfeitures and returning a record $560 million to the public.
Breanne Deppisch is a national politics reporter for Fox News Digital covering the Trump administration, with a focus on the Justice Department, FBI and other national news. She previously covered national politics at the Washington Examiner and The Washington Post, with additional bylines in Politico Magazine, the Colorado Gazette and others. You can send tips to Breanne at Breanne.Deppisch@fox.com, or follow her on X at @breanne_dep.
https://www.foxnews.com/politics/doges-medicaid-data-dump-aims-expose-fraud-privacy-legal-hurdles-loom