WASHINGTON, D.C. – Yesterday, Congressman Brett Guthrie (KY-02), Chairman of the House Committee on Energy and Commerce, and Congressman John Joyce, M.D. (PA-13), Chairman of the Subcommittee on Oversight and Investigations, continued their fight against fraud in Medicaid programs across the country… while Democrats used our most vulnerable Americans as a political football denying that evidence of widespread Medicaid fraud exists and claiming that Republicans’ efforts to combat Medicaid fraud are merely a political exercise.
Even after three hearings held in the Energy and Commerce Committee’s Subcommittee on Oversight and Investigations, Democrats still refuse to acknowledge that fraud schemes occurring nationwide within government health programs are real, plentiful, destructive, and in some cases, even lethal.
In January 2026, two individuals pleaded guilty to a seven-year $68…
MANAGEMENT & CULTURE (THE “TONE AT THE TOP”)
Fraud thrives in “sloppy” environments where leadership ignores the rules.
- The Fraud Triangle: For fraud to occur, three elements must be present: Pressure (the need for money), Rationalization (thinking “I deserve this”), and Opportunity (weak controls). You can only control the Opportunity.
- Whistleblower Hotline: Provide an anonymous way for staff to report “odd behavior.” Most internal frauds are caught via tips, not audits.
- Background Checks: Conduct credit and criminal record checks for all employees in financial or data-sensitive roles.
- Annual Ethics Training: Make sure every staff member knows that the company has a Zero Tolerance policy toward “borrowing” from petty cash or fudging overtime.