Tag: fraud

  • ACA Enrollment Fraud Now Tops 6 Million — And Taxpayers Are Footing a  Billion Bill

    ACA Enrollment Fraud Now Tops 6 Million — And Taxpayers Are Footing a $27 Billion Bill

    A sweeping new report released today confirms what critics of the Affordable Care Act have warned for years: millions of ineligible individuals are receiving federally subsidized health coverage, draining tens of billions in public funds through a system riddled with structural loopholes and almost no accountability.

    6.2M+
    Improper enrollees (2026 est.)
    $27B
    Annual taxpayer cost (2025)
    ~96%
    Fake GAO apps approved (2024-25)

    In what is shaping up to be one of the most significant federal health care accountability stories of the year, the Paragon Health Institute released findings today — confirmed by The Washington Post — estimating that roughly 6.2 million people on the ACA’s health insurance exchanges are improperly enrolled in subsidized coverage. That figure represents approximately one in four of all exchange enrollees, according to the think tank’s analysis.

    The report lands as Congress continues debating the future of COVID-era enhanced subsidies that have ballooned ACA enrollment numbers — numbers now called into serious question by researchers, federal watchdogs, and the courts alike.

    “Roughly a quarter of all ACA exchange enrollees may be receiving coverage they are not entitled to — paid for by American taxpayers.”

    — Paragon Health Institute, June 2026

    HOW IT HAPPENED

    The story of ACA fraud is inseparable from the pandemic. When Congress passed enhanced subsidies in 2021 that effectively made silver and bronze plans free for low-income enrollees, brokers and insurers quickly found ways to exploit the windfall. Income verification requirements were loosened. Enrollment could be triggered through Direct Enrollment pathways with minimal scrutiny. And crucially, the financial penalty for overstating income — and thus receiving excess subsidies — was capped so low it created almost no deterrent.

    The result, according to Paragon’s research, was a surge in fraudulent sign-ups driven by three overlapping groups: enrollees who deliberately misstated their income; unscrupulous brokers who falsified applications to earn commissions; and a class of enrollees who were signed up entirely without their knowledge or consent, with insurers and agents pocketing the subsidy payments.

    The scale of that last category is particularly alarming. Centers for Medicare and Medicaid Services (CMS) data show that nearly 12 million ACA enrollees — 35% of all exchange participants — filed zero medical claims in 2024, up from just 3.5 million in 2021. Researchers describe many of these as “phantom enrollees”: people who have no idea they are technically covered, or who have other insurance entirely.

    GOVERNMENT’S OWN TESTS CONFIRM THE HOLES

    The Government Accountability Office (GAO) conducted two rounds of undercover testing — and the results were stunning. In the first round, GAO submitted four fictitious applications for plan year 2024 using invalid Social Security numbers and fabricated identities. All four were approved, costing approximately $2,350 per month in fraudulent subsidies. In the second round, GAO submitted 20 fictitious applications for plan year 2025; 19 of the 20 were approved and, as of September 2025, 18 were still actively receiving subsidized coverage. Combined across both rounds, the exchange approved 23 of 24 fictitious applications — a 96% failure rate for basic fraud detection.

    The Congressional Budget Office (CBO) added its own corroboration, estimating 2.3 million improper enrollees just among those who overstated their income in the ten states that did not expand Medicaid — a fraction of the total picture. The CBO figure alone exceeds the total coverage losses Democrats claim will result from ending the enhanced subsidies, a point Republicans have seized upon in the ongoing budget debate.

    CRIMINAL PROSECUTIONS MOUNT

    The fraud is not only a policy problem — it is increasingly a criminal one. In February 2025, a federal grand jury indicted Cory Lloyd and Steven Strong for a scheme that sought over $233 million in fraudulent ACA subsidies, of which the federal government paid at least $180 million. Both men targeted vulnerable, low-income individuals — including people experiencing homelessness, unemployment, and substance use disorders — and used street marketers who sometimes offered bribes to induce enrollment. Both were convicted by a federal jury in November 2025 and sentenced to 20 years in federal prison each, with $180.6 million in restitution ordered.

    In April 2026, the Department of Justice announced a separate but related resolution: AP of South Florida (APSF), the brokerage company where Lloyd had continued the scheme, agreed to plead guilty to one count of major fraud against the United States. The federal government had paid $141.5 million in unwarranted subsidies through APSF. In a parallel civil resolution, APSF’s parent company AssuredPartners agreed to pay $135 million to resolve False Claims Act allegations. The combined settlement exceeds $160 million. Court documents revealed that APSF employees stationed street marketers at homeless shelters, bus stops, and drug treatment clinics — sometimes offering cash or gift cards to obtain personal information. Some victims subsequently lost Medicaid access and faced increased costs for HIV medication, opioid treatment, and mental health drugs.

    FLORIDA: GROUND ZERO

    Florida has emerged as the leading state for ACA enrollment fraud. A Paragon county-level analysis found that in nearly every Florida county, ACA enrollment exceeds the estimated eligible population — in some counties by more than eleven times. Note: independent health policy researchers, insurers, and hospital groups have disputed Paragon’s methodology, contending the fraud estimates may be overstated. The state’s combination of high poverty rates, large uninsured populations, and a dense network of commission-driven insurance brokers created conditions that, according to federal prosecutors, allowed large-scale fraud to operate for years.

    WHAT REFORM COULD LOOK LIKE

    Critics of the ACA say the path forward is straightforward but politically difficult: allow the pandemic-era enhanced subsidies to fully expire, raise the subsidy repayment caps that currently let overpaid enrollees keep the excess with little consequence, and restore meaningful income verification requirements at the point of enrollment. CMS under the current administration has signaled support for tighter controls, with Administrator Dr. Mehmet Oz stating in mid-2025 that the agency is “restoring integrity to ACA exchanges by cracking down on fraud.”

    Defenders of the program argue the fraud figures are overstated and that any tightening of enrollment rules will disproportionately harm low-income Americans who legitimately need coverage — a tension that is now at the center of one of Washington’s defining health policy battles. What is no longer in dispute, after years of accumulating evidence from GAO, CBO, CMS, and federal prosecutors alike, is that billions of taxpayer dollars have flowed to people who were never supposed to receive them.

    TIMELINE

    2021–2022 Biden-era COVID subsidies introduced; income verification requirements loosened. Lloyd-Strong and APSF fraud schemes begin operating across Florida.
    June 2024 Paragon publishes ‘The Great Obamacare Enrollment Fraud,’ estimating 5.0 million improper enrollees in 2024 (revised upward to 5.1M in May 2026).
    Dec 2025 Enhanced COVID subsidies expire. GAO releases undercover results: 23 of 24 fictitious applications approved across plan years 2024–2025. Paragon documents 6.4M+ improper enrollees in 2025.
    Feb 2025 DOJ indicts Cory Lloyd and Steven Strong for a scheme seeking $233M+ in fraudulent ACA subsidies (at least $180M paid), targeting homeless individuals and people in treatment programs.
    Nov 2025 Both Lloyd and Strong convicted by federal jury; each sentenced to 20 years and ordered to pay $180.6M in restitution.
    Apr 2026 APSF pleads guilty; AssuredPartners pays $135M civil settlement. DOJ total exceeds $160M — one of the largest ACA fraud resolutions on record.
    Jun 2, 2026 Paragon releases updated estimates: 6.2M+ improper enrollees in 2026, confirmed by Washington Post. Congressional reform debate intensifies.

    SOURCES & KEY LINKS

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  • Feeling Like a Fraud in Your Own Mindfulness Practice

    Feeling Like a Fraud in Your Own Mindfulness Practice

    Over the years, I’ve worked closely with many meditation practitioners and Buddhist authors, some of whom have been clients, and my own practice has grown alongside those relationships. Being surrounded by people with such depth of experience can be inspiring, but it can also quietly raise the bar for where you think you should be in your ability to navigate life’s difficulties.

    One of the most humbling moments for me came during a trip to the emergency room related to complications from my autoimmune disease. I was in excruciating pain when a close friend, who also has a long meditation practice, asked, half joking, “Are you able to outsmart your pain?”

    We both laughed. The joke landed because another friend of mine, physician and meditation teacher Dr. Christiane Wolf, is a colleague and former client who has written about working with chronic pain through mindfulness in her book Outsmart Your Pain.

    I remember telling her at one point, almost defensively, that I meditate every single day. I had this quiet, competitive edge about it. I did not want to miss a day, even in the hospital. Missing a day felt like a failure.

    I remember telling her at one point, almost defensively, that I meditate every single day. I had this quiet, competitive edge about it. I did not want to miss a day, even in the hospital. Missing a day felt like a failure. In hindsight, that belief feels a little ridiculous, but at the time, it carried real weight.

    At that moment, I was not able to outsmart my pain.

    My response was immediate: “No. I’m not able. I’d like the pain meds.”

    Even as I said it, a small part of me felt inadequate. I was feeling like a fraud. If I had spent years around mindfulness practitioners and teachings about working skillfully with pain, shouldn’t I be better at this?

    Health challenges have given me many moments like that, moments when I questioned my ability to navigate difficulty in the way I believed I should.

    What I didn’t understand at the time was that practice does not always show up in the exact moment of distress. Sometimes it shows up in how we move through the experience afterward.

    Christiane later offered a perspective that shifted something for me.

    “Angela,” she said, “if you’re not meditating when you’re hospitalized, it doesn’t make you a failure. Your practice to date has prepared you to navigate these moments. That’s what the practice is for.”

    “Angela,” she said, “if you’re not meditating when you’re hospitalized, it doesn’t make you a failure. Your practice to date has prepared you to navigate these moments. That’s what the practice is for.”

    It was a simple reminder, but an important one. I realized how quickly I had turned a moment of human vulnerability into a judgment about whether I was doing the practice “well enough.”

    Around the same time, I was helping a menopause telehealth company develop educational content and share mindfulness practices for women navigating perimenopause and menopause. I had no trouble guiding others through meditation or creating resources that helped people access the practice.

    Yet privately, I sometimes struggled to apply the same steadiness to my own life.

    That tension, between helping others access mindfulness and questioning my own ability to embody it, was incredibly revealing. It showed me how quickly self-judgment can creep in, and how easily I hold myself to impossible standards. More importantly, it helped me see where I still have work to do, on the cushion and off.

    Naming the Experience

    As months passed, I became more curious about what might be happening beneath the surface of my experience. I understood the stress and anxiety tied to my health challenges. Those had been part of my life for years. But this felt deeper.

    I began to question my beliefs about how I was supposed to handle difficulty. Clearly, I had internalized an idea of what this should look and feel like, especially for someone with as much mindfulness experience as I had. After more than 15 years working in this space, I had unconsciously decided that I should not be struggling at all.

    I began to question my beliefs about how I was supposed to handle difficulty. Clearly, I had internalized an idea of what this should look and feel like, especially for someone with as much mindfulness experience as I had. After more than 15 years working in this space, I had unconsciously decided that I should not be struggling at all.

    Psychologists have a term for a similar pattern in professional life. The impostor phenomenon, first described by Pauline Clance and Suzanne Imes in 1978, refers to the persistent feeling that we are falling short of a role we are supposed to inhabit, even when there is ample evidence that we belong there.

    While this concept is often discussed in career settings, a similar dynamic can arise in contemplative practice.

    Experienced practitioners are still human. We can be just as overwhelmed by everyday stressors as anyone else, and often, the mind is quick to judge that experience. Mine tends to sound like, If you were truly a mindfulness practitioner, you wouldn’t be feeling this way.

    In those moments, the mind takes a very human experience and reframes it as failure. You’re an impostor.

    Part of what makes this so challenging is that we begin looking for evidence to support that belief, convincing ourselves we are failing at something we were never meant to perfect.

    Part of what makes this so challenging is that we begin looking for evidence to support that belief, convincing ourselves we are failing at something we were never meant to perfect.

    What About Stress?

    To be alive in these times is to experience sustained levels of stress. It does not take much, turning on the news, scrolling through headlines, or navigating daily responsibilities, to feel the weight of political unrest, global uncertainty, financial pressure, social division, and personal strain.

    The nervous system absorbs all of it.

    So how do we regulate ourselves in the midst of this? And what does this have to do with mindfulness impostor syndrome?

    Research in stress physiology shows that when the brain perceives a threat, the body shifts into survival mode. Heart rate increases, breathing changes, and attention narrows toward potential danger.

    In these states of activation, it can feel much harder to access the awareness we have worked so hard to cultivate. This can create a confusing internal signal: If I have these tools, why can’t I use them right now?

    For mindfulness practitioners, this can easily be misinterpreted as a failure of practice.

    But the nervous system is not malfunctioning in these moments. It is responding exactly as it was designed to.

    This misunderstanding is where self-doubt can quietly take hold.

    Clear Seeing

    One of the most widely cited insights from psychiatrist Carl Jung is, “Until you make the unconscious conscious, it will direct your life and you will call it fate.”

    As mindfulness practice deepens, awareness expands. We become more attuned to our internal landscape, our thoughts, emotions, and reactions. As a result, we often begin to notice reactivity more clearly than we did before. What can feel like regression may actually be increased awareness.

    As mindfulness practice deepens, awareness expands. We become more attuned to our internal landscape, our thoughts, emotions, and reactions.

    As a result, we often begin to notice reactivity more clearly than we did before.

    What can feel like regression may actually be increased awareness.

    You might notice yourself getting triggered in situations where, in the past, you would have reacted automatically without even realizing it. Now, there is a pause. A recognition. A moment of seeing what is happening.

    That shift can feel uncomfortable, not because something is going wrong, but because something is being revealed.

    Research on mindfulness suggests that practice strengthens meta-awareness, our ability to observe our own mental and emotional states.

    The reactions themselves may not be new.

    What is new is our ability to see them.

    Expectations and Shame Are Here!

    Most of us carry an internal narrative, one that quietly projects expectations onto our daily lives. In mindfulness practice, this often takes the form of how we think we should feel when we sit.

    Calm. Patient. Equanimous. Grateful.

    We tend to measure success by the presence of these states, while overlooking the full range of human emotion, fear, anger, grief, uncertainty, that are equally part of our experience.

    We tend to measure success by the presence of these states, while overlooking the full range of human emotion, fear, anger, grief, uncertainty, that are equally part of our experience.

    When our lived reality does not match that internal expectation, shame can arise.

    During the months leading up to menopause, I found myself navigating unfamiliar sensations in my body. Many of my tools seemed to disappear. I felt reactive, scared, and uncertain about what was happening.

    And the narrative that followed was harsh:

    You should be handling this better.

    Who are you to guide others if you cannot manage this yourself?

    Instead of simply noticing stress, I added another layer: self- judgment.

    At times, mindfulness concepts themselves can become a form of pressure. Psychotherapist John Welwood described this dynamic as “spiritual bypassing,” using spiritual ideas to avoid or override difficult emotional realities.

    In practice, this can show up in subtle ways, but the result is often the same. We begin to feel guilt or shame about what we are experiencing.

    Dealing with Dysregulation

    Our ideas about mindfulness can sometimes work against us. If we believe the practice should make us calm and less reactive at all times, we set ourselves up for disappointment.

    Mindfulness is not about performing calmness.

    Mindfulness is not about performing calmness.

    As Allen Ginsberg once said, the task is simply to “notice what you notice.”

    When we cultivate awareness, we begin to see our reactions as they arise. Maybe you notice yourself getting triggered in a conversation. Maybe you pause instead of immediately reacting. Maybe you recognize, even afterward, that you were overwhelmed.

    These moments matter.

    Mindfulness meets us exactly where we are.

    It does not require that we arrive in a particular state.

    It asks us to meet whatever state we are in with a bit more awareness, and when possible, a bit more kindness.

    Research on self-compassion suggests that responding to difficult emotions with care rather than criticism supports emotional resilience and regulation.

    When we approach our experience this way, the narrative of failure begins to soften.

    Anyone who has spent time meditating knows that emotions will always arise. What changes is not the presence of emotion, but our relationship to it.

    Instead of asking, Why am I still reacting like this?

    We might ask:

    What is happening in the body right now?

    What is this reaction trying to tell me?

    These questions reopen the possibility of practice, even in the middle of difficulty.

    Anyone who has spent time meditating knows that emotions will always arise. What changes is not the presence of emotion, but our relationship to it.

    Moments of reactivity do not disqualify us from the practice.

    They remind us why we practice. Awareness is not something we perfect. It is something we return to, again and again.



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  • Arizona Pastor Accused of Medicaid Fraud After Submitting False Claims Worth Millions: Attorney General

    Arizona Pastor Accused of Medicaid Fraud After Submitting False Claims Worth Millions: Attorney General

    An Arizona pastor has been indicted alongside 16 others in a sweeping Medicaid fraud case, accused of helping funnel millions in state healthcare funds through fake rehab claims and laundering the proceeds through his church, state officials announced.

    A grand jury indicted 17 individuals and two organizations, including Hope of Life International Church and its pastor, Theodore Mucuranyana. Authorities allege that from August 2022 to July 2023, co-defendants Desire Rusingizwa and Fabrice Mvuyekure used their business, Happy House Behavioral Health, to submit more than $60 million in fraudulent Medicaid claims, according to AZ Central.



    Prosecutors allege that the company billed for services to patients who were deceased, incarcerated or hospitalized—and funneled more than $5 million to the church as the investigation loomed.

    Most defendants were scheduled to be arraigned between May 20 and May 27. Mucuranyana and the church face money laundering charges, while Happy House has been suspended from the Arizona Health Care Cost Containment System. Assets including luxury goods and properties are now subject to seizure as part of ongoing investigations.

    The pastor’s lawyer told 12 News that he knew “nothing” about the alleged fraud.

    Since Attorney General Kris Mayes took office in early 2023, over 100 people across 14 cases have been charged following accusations of exploiting the system—largely by billing for nonexistent alcohol and drug rehabilitation services,

    Officials say more indictments could follow as investigations continue into how widespread the misuse of state funds may be.

    Originally published on Latin Times

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