Last year, we wrote in the Los Angeles Times that the Centers for Medicare and Medicaid Services was done chasing criminals after we’d already handed them money. We said we were building something different — a prevention-first operation that would detect and stop fraud before the check cleared, not attempt to claw back lost funds years later.
Skeptics had reason to doubt. Government agencies announce transformations all the time. The results usually don’t follow.
So here are the numbers:
In fiscal year 2025, Medicare savings from the prevention of fraud, waste and abuse hit $42 billion — an almost 60% increase over the prior year and the highest figure ever recorded in the program’s history. That’s not just a line on a spreadsheet. In Medicare’s coffers, $42 billion can pay for 3 million knee replacements, 7 million cataract removals or 37.5 million routine colonoscopies.
Finding and…
Identity theft is the “foundational” fraud upon which many other crimes are built. It involves the unauthorized acquisition and use of a person’s personal identifying information (PII), such as an ID number, Social Security number, or passport details.
- How it works: Fraudsters obtain PII through data breaches, mail theft, or “social engineering” (tricking people into revealing details). Once they have this data, they can open new bank accounts, apply for credit cards or loans, and even receive medical treatment under your name.
- Synthetic Identity Fraud: A sophisticated variation where criminals combine real and fabricated information to create a completely new, “synthetic” person. This is particularly difficult to detect because there is no single victim to report the suspicious activity initially.