A series of allegations and investigations have surfaced regarding Medicaid and Medicare Advantage programs, highlighting improper payments, fraud, and money laundering schemes. Pennsylvania reportedly led the nation in Medicaid fraud charges in 2024, with improper Medicaid payments potentially amounting to $1.3 trillion. Health insurers, including Centene ($620 million), Elevance Health ($346 million), and UnitedHealth ($298 million), allegedly collected $4.3 billion in taxpayer money through double-enrolled Medicaid patients in different states. Additionally, the California Public Employees’ Retirement System (CalPERS), the largest U.S. pension fund with $500 billion in assets, has filed an amended lawsuit against UnitedHealth Group. The lawsuit accuses the company of concealing an illegal upcoding scheme in its Medicare Advantage business, which allegedly inflated its stock value and misled investors. The suit cites damning media reports, government investigations, and a Justice Department probe into UnitedHealth's practices. Reports also reveal that states and providers have engaged in Medicaid money laundering schemes, using financing tactics to shift costs to the federal government. These practices have reportedly led to inflated Medicaid spending, windfall profits for hospital systems, and increased taxpayer burdens. Calls for reform include limiting provider taxes and enhancing transparency in Medicaid financing.