Citizen sleuths spotlight red flags galore in government spending

NEW ORLEANS, La.—Although they received millions of taxpayer dollars, it can be hard to find the offices of health service providers in the Big Easy.

Consider Faith and Hope of New Orleans, a home health agency that took in $11.6 million from the Centers for Medicare and Medicaid Services (CMS) between 2018 and 2024. The company’s website, as well as federal and state databases, lists its address at 3720 Gentilly Street.

But RealClearInvestigations only found an empty building at that location last week. Repeated phone calls during working hours to the listed number connected to a service, whose operator said, “I don’t know why they’re not answering.”

Similarly, AAA Care, which received $13.4 million in taxpayer money from 2018-2024, shows up at various addresses. The business is on South Rampart Street, according to the federal National Provider Identifier and many web listings, but the building’s owner told RCI that AAA had vacated the site “about a decade ago.” The Louisiana Department of Health puts the company in the suburb of Metairie. The company does not list an address on its new website, while yet another site has it on Canal Street. Using the state’s number, RCI reached AAA Care, which the operator said was on Canal Street, and spoke briefly with owner Stephanie Jackson, but she did not make herself available for an interview.

Businesses move, of course, but it seems curious that two companies receiving more than $25 million should be so difficult to locate. People who scour government data for fraud, however, say it is common to come across entities receiving millions of taxpayer dollars that do not seem to operate like normal businesses.

Walter Curt, an independent writer who created an interactive map RCI used to identify providers, said tracing government spending can feel like a series of rabbit holes.

“They [the government and providers] don’t know, and they don’t want you to know,” about their operations, he told RCI. “We’ve got home health care paid for in the U.S. that is basically untraceable. There is no real oversight given to hundreds of billions of dollars spent.”

Curt, proprietor of the W.C. Dispatch website, is part of a growing brigade of Americans exposing what appears to be surprising or inexplicable government spending. Armed with laptops and cellphones, and galvanized by Nick Shirley’s videos that attracted attention to billions of questionable payments in Minnesota, squads of what are being called “citizen journalists” have raised the cry that possibly fraudulent activity is widespread.

Spotlight on Fraud

Their spotlights come as President Trump has made uprooting endemic fraud and waste a priority of his administration, naming Vice President JD Vance his fraud czar. That appointment comes a year after Trump’s Department of Government Efficiency (DOGE) roiled the federal government’s cozy network of agencies, nonprofits, and non-governmental organizations that had benefited for decades from massive transfers of taxpayer money to the groups.

The federal government – especially through its 74 offices of Inspector General – has long investigated fraud. Yet it was only last month that wide attention was paid to the exponential rise in autism therapy payments, for example. In Minnesota, those rose from about $1 million in 2017 to $343 million in 2024, and there are now allegations of kickbacks. The Wall Street Journal labeled autism therapy in Indiana a “jackpot,” reporting on ongoing work by the Department of Health Human Services IG that found one autism provider was receiving $640 an hour for autism services that are normally billed at a fraction of that cost.

The combination of the Trump administration’s focus on the issue, plus the legions of independent diggers it has inspired, has raised larger questions about the ability of government to oversee entities spending its trillions. The new investigators have uncovered dubious spending in day care centers, commercial trucking licensing, and, most prominently, in the government’s massive health-care programs, Medicaid and Medicare.

Proving how much of this is actual fraud is a complicated matter, and the best of these social media and online investigators insist they are making no concrete accusations. Indeed, much of the questionable spending may be entirely legal given current reimbursement rules. The abundance of obvious yet largely ignored red flags identified, however, suggests a troubling pattern.

“The long story short is we need to make a new word for ‘legal, but also obviously fraud,’” said Jennica Pounds, known on X as DataRepublican(small r). She is convinced a large portion of what has been highlighted smacks of corrupt, if not criminal, practices.

Pounds, who describes herself as “just a tool builder,” has emerged in the past year as one of the most astute analysts of patterns in government spending. In a series of recent posts on X about nearly $4 billion in Medicaid claims going to a ZIP code in Brooklyn with just over 30,000 people, she noted that this would mean each person there was getting $143,000 in care, a figure she says “defies belief.”

“I don’t think the NY data has fraud signals in and of itself,” Pounds told RCI via email. “But it’s still a fact that NY has something like 68% of all home-care billing in the nation, so naturally that made centralized billing agencies like Brooklyn stick way, way out.”

The phenomenon has even pushed some into seeking elected office. Bailey Templeton is now running for Congress in Illinois after discovering that in just five years, Medicaid payments there to children without Social Security numbers jumped 725%, hitting $66 million in 2025.

“Do I think these people have been good stewards of taxpayers’ money? Absolutely not,” Templeton said.

Citizen Sleuths

There are lots of leads for Vance to pursue with his new duties, but it is unsurprising that many of them come from healthcare spending, which dwarfs all other government programs. In the current fiscal year, the Department of Health and Human Services, which handles payments to hospitals and prescription drugs, in addition to the Centers for Medicaid and Medicare (CMS), accounts for about one-third of Washington’s budget with $1.2 trillion. The department has some $2.46 trillion in “budgetary resources” available, a figure 85% greater than the Defense Department’s budgetary resources, the next closest agency, according to Treasury figures at usaspending.gov.

Reports of fraud and misspending at CMS have a long history. In 2008, for example, The Washington Post reported that “Medicare pays most claims without review,” and so far this year, more than half of the 24 reports the DHHS Inspector General has published concerned the Centers, whose Medicaid and Medicare grants currently account for more than one-third of the department’s budget.

Now citizen journalists are scouring the spending.

They are using the February data dump of Medicaid provider information that came from the Department of Government Efficiency, which is still operating, albeit with fewer headlines. Former DOGE head Elon Musk hailed the dump as a big moment in transparency, and he and others said it should help identify fraud, although privacy concerns and complicated rules and regulations make that accusation difficult to prove.

It is that dump Curt said he mined to create his interactive map and “user guides” for specific geographic areas that he offers for sale in hopes more people will examine spending in their neighborhoods.

Using what he said is a proprietary algorithm, Curt gave all the businesses a “priority rating,” ranging from low to critical. He cautioned, however, that he was not leveling any specific accusations, but rather highlighting spending patterns that stand out.

“That’s a form of triage, really; it’s not conclusive,” he said. “We just don’t know. We do know that there’s a bunch of really weird spending trends here.”

Using Curt’s map, RCI crisscrossed the New Orleans area seeking comment from the listed companies. The map does not reflect the sort of concentration CBS News recently found in Los Angeles, where 89 hospice agencies are housed in one office plaza, and roughly a third of the more than $450 million paid in New Orleans went to Ochsner Medical Center, the city’s largest, and the city’s Children’s Hospital.

Many Questions, Few Answers

Still, there were several curious finds among the other recipients. As noted, several no longer remain at the addresses listed by CMS or Louisiana state records, RCI found.

Of the half-dozen listed providers RCI visited from Kenner to New Orleans, only two were open at that address. One, Penn 123 LLC, is a recovery addiction center that received $16.2 million according to the data, but a worker there said she was unfamiliar with the billing process, and a phone call to the center was not returned.

At the second, Advance Home Care Services on North Broad Street, which received $11 million between 2018 and 2024, a worker also professed ignorance about billing. She said it usually had about 70 patients at any one time, many elderly, for whom it would provide cleaning, cooking, bathing, and other services on home visits. She said patients choose it or another company from a “freedom of choice” list compiled by the state.

Neither RCI’s experience nor the work of Pounds, Curt, and others provides clear evidence that anything illegal has transpired. Rather, they reflect a system that seems curiously lax despite the huge sums of taxpayer money being spent. No one can knock on every door or monitor every recorded patient and visit to determine what is happening in a system so vast and opaque.

It does not take much to rack up substantial billings under Medicaid and Medicare. The average cost of a home-care hospice visit of the type described by Advance Home Care, which also appears to be the main work of many of the New Orleans providers on the interactive map, costs between $150 and $200, according to the industry. Using the low end of that average, a business with 70 clients would thus bill $21,000 a week if it visited them each twice.

“Congress has made it so easy for people to bill Medicare and Medicaid, and uses so few antifraud measures, that those programs are effectively giant ATMs,” said Michael Cannon, a health-care expert at the libertarian Cato Institute. “Anyone who punches in the right numbers can make off with bags of cash.”

Yet what is striking about the revelations in 2026 is that so many of them are coming from private citizens rather than government officials and algorithms that might be expected to pinpoint potentially dubious spending amounts and patterns, such as steep, rapid rises in payments.

“How on earth could you investigate it all?” Curt asked. “How many cities have a police department with a 200-person white collar crime unit?”

The Justice Department does have “75 experienced white-collar prosecutors dedicated exclusively to prosecuting the nation’s most complex health-care fraud matters,” and a Gulf Coast “strike force” with its hub in New Orleans. The Department did not respond to a request for comment about the healthcare task force’s work in the city.

Designed for Failure

Another layer that seems to insulate the system from more oversight is the fact that the federal government is the main source of Medicaid and Medicare money, but the day-to-day operation of the programs is run at the state level. In other words, one group can point fingers at the other’s shortcomings. CMS Administrator Dr. Mehmet Oz insisted the Centers are amping up efforts to end fraud.

“Stealing from people at the most vulnerable moment of their lives isn’t just fraud, it can cost them their future,” he said in a statement to RCI. “When bad actors trick patients into fraudulent care, they don’t just drain taxpayer dollars; they strip people of medical care that could help them live longer. That’s unconscionable, and CMS is going to drive these predators out of the health system.”

Some have pushed back against this citizen sleuthing, even as the people calling attention to it carefully note the limitations of their data. In New York state, for example, Health Department officials insist they have policed potential fraud aggressively, and that all these flags should not be interpreted as warning signs.

Damine LaVera, a spokesman for the New York State Department of Health, said criticism like Pounds’ is rooted in politics, not policing.

“This is not a serious exercise, it is an intentionally disingenuous effort by an anonymous, clearly partisan X account who is obviously working backward from a conclusion that fits an ideological and political agenda,” LaVera said.

But New York officials did not dispute Pounds’ numbers, insisting instead they have been yanked out of context and do not, on their face, indicate anything untoward.

“Rather than following the lead of conspiracy theory social media accounts masquerading as amateur auditors, follow the facts: under the leadership of Governor Kathy Hochul and through the independent work of the Office of the State Comptroller, the Office of Medicaid Inspector General, the Department of Health and law enforcement, New York State has taken concrete steps to root out waste, fraud and abuse in Medicaid,” LaVera said.

Murky Data

As an example of how a figure can be misleading, New York officials pointed to companies they use to streamline operations. That means that while one data “dot” may show a huge sum, that money did not all go to one source but is instead distributed to many.

Longtime professional trackers of government data also said they are never sure of the threads about public spending that are proliferating on social media. OpenTheBooks, for instance, has been trying to make public “every dime” of government spending and has amassed “the largest private database” of such activity.

“I’m always a little skeptical of these reports, as I don’t know how to check all these numbers on social media,” said Jeremy Portnoy, an investigative reporter with OpenTheBooks who also contributes to RCI. “You don’t always know or can’t tell where they’re getting their data, and it can be tough to go beyond the allegations. You figure these people are probably right, but they don’t really prove that conclusively.”

Mere statistics are not a reliable source for uncovering fraud, and glaring examples can make the problem seem worse or more systemic than it is, other experts noted.

“I’m generally wary of using statistics only as a method of finding actual fraud,” said Jeremy Nighohossian, a health-care analyst with the conservative Competitive Enterprise Institute. “Basically, they’re flagging outliers and there will always be some outliers. But it’s really hard to find fraud, harder than you think, and the fraudsters may morph much faster than the bureaucracy that’s supposed to catch them.”

What’s happening, then, in many cases, isn’t fraud in the criminal sense, but rather, as Pounds suggested, people are taking advantage of a system with gaping loopholes. And there is little built-in incentive from administrators to catch them.

“People think I’m kidding when I say there is a fraud lobby, but there are absolutely powerful interest groups that lobby Congress to preserve the ease with which people can get money from these programs,” Cannon said. “With health the largest category of federal spending, those programs are vastly more complex, and subsidy recipients have even less patience for antifraud measures.”

In New York, California, Minnesota, Louisiana, and elsewhere, bags of cash are clearly being distributed. And thus far, while some officials dismiss the posts and stories on the grounds that it’s unclear where the data used is coming from, none of them have said the numbers used by Pounds, Curt, Shirley, and others are wrong. Consequently, it suggests a closer look by whatever team Vance puts together is in order.

“Obviously if I was wrong, they’d be issuing cease-and-desist orders or claiming my numbers are way off,” Templeton told RCI. “But nothing like that has happened so I assume I am correct.”