State of The Nation

Protecting a Lifeline for Chronic Disease Patients While Closing the Door on Fraud  Investigative Policy Analysis  ·  IPCSG Research Series  ·  February 21, 2026 Health Policy & Program Integrity February 21, 2026  ·  Medicare Policy Analysis Bottom Line Up Front (BLUF) Telehealth is not a luxury for the chronically ill — for cancer patients, dialysis patients, and those managing complex multi-drug regimens, it is a clinically validated, cost-effective necessity. The evidence shows that well-designed telehealth does not increase downstream hospitalizations or emergency visits. The fraud problem is real but traceable to a specific, identifiable set of bad actors — fly-by-night telehealth mills, fraudulent DME schemes, and unscrupulous genetic testing companies — not to the established patient-physician relationships that responsible telehealth protects. The policy solution is not restriction, but pre...

What Every Senior Needs to Know — and Do — to Guard Their Benefits BOTTOM LINE: Medicare fraud is not an abstract government problem — it directly threatens your benefits, your credit, and your personal medical identity. Beneficiaries who actively monitor their accounts, guard their Medicare number, and promptly report suspicious charges are the single most effective line of defense. Most fraud victims had no idea it was happening until significant damage was done. WHY THIS MATTERS DIRECTLY TO YOU When fraudsters bill Medicare in your name — for services you never received, equipment you never ordered, or visits from providers you never saw — several serious consequences follow: Your Medicare records become corrupted with false diagnoses, procedures, and prescriptions that future physicians may act on. Your coverage limits for certain services (skilled nursing, home health, durable medical equipment) can be exhausted by fraudulent claims before you actually need them. Your personal ...

  INVESTIGATIVE REPORT How Fraud, Waste, and Abuse Are Hollowing Out America's Medicaid and Medicare Programs February 21, 2026  |  Special Investigative Report BLUF (Bottom Line Up Front): Federal health entitlement programs — Medicaid and Medicare — disbursed over $1 trillion in Medicaid payments alone from 2018 to 2024, with the Department of Health and Human Services (HHS) estimating that between $60 billion and $100 billion is lost annually to fraud, waste, and abuse across both programs. New transparency data released by HHS in February 2026 exposes explosive billing-code growth of up to 10,283%, a concentration of payouts among a handful of organizations, and systemic vulnerabilities that have persisted across multiple administrations. Aggressive enforcement, real-time data monitoring, and congressional oversight are urgently needed to protect American taxpayers and the program's most vulnerable beneficiaries. BACKGROUND: THE SCOPE OF FEDERAL HEALTH SPENDING The Un...