A recently released Financial Trend Analysis, “
Health Care Fraud: Trends in Bank Secrecy Act Data.” from the Department of the Treasury’s Financial Crimes Enforcement Network (FinCEN), provides threat pattern and trend information on potential health care fraud-related activity based on Bank Secrecy Act (BSA) reports filed with FinCEN between March 1, 2025 and February 28, 2026 and identified approximately $17.5 billion in suspicious activity.
Among FinCEN’s findings were that suspected health care fraud-related schemes targeted a mix of Medicare, Medicaid, and private insurance programs, with Medicare and Medicaid named in approximately 38% of FinCEN’s dataset. Medicare payments frequently originated from Medicare Administrative Contractors covering Medicare Part A and B claims, while Medicaid payments originated from state-level administrators.
Additionally, home health care businesses were the most frequently identified suspected fraudulent providers, with the majority of them registered at residential homes. Other frequently identified providers included hospice and adult or child daycares.
The Financial Trend Analysis found that the level of sophistication among suspected fraud perpetrators varied widely and that the majority of BSA filers described activity involving purported health care providers that did not appear to offer any medical services.
Among the few cases where seemingly legitimate medical providers engaged in potentially fraudulent practices, the providers appeared to have engaged in fraudulent billing, accepted kickbacks, or provided medically unnecessary services. FinCEN did note, however, that the segment of health care fraud involving seemingly legitimate providers may have been underrepresented in the dataset, as these businesses have fewer obvious red flags for financial institutions to detect.
In the
press release accompanying the release of the Financial Trend Analysis, Treasury is encouraging whistleblowers to report credible information related to fraud as it seeks to deliver on the administration’s commitment to eliminating fraud and safeguarding the integrity of federal health care programs.