Sources for the figures and statutory claims on this site.
Each number used anywhere on this site appears below with its exact source. Figures are drawn from CMS, the U.S. Department of Justice, HHS OIG, and GAO. Each numbered reference below links the site claim to its source.
A note on improper payments
Improper payments are not fraud. CMS states that improper payment measurement is not a measure of fraud. An improper payment is a payment that did not meet program payment requirements. It can be an overpayment, an underpayment, or a payment where there was not enough information to tell.1 Source 1, see sources page
In some programs an improper payment reflects a missed administrative step that, had it been completed, would have resulted in a proper payment.1 Source 1, see sources page
This site uses those estimates to describe the scale of the payment-integrity problem, never as an estimate of fraud. The analysis sets out where each estimate is used and what it does and does not show.
Documents
Each entry is keyed to the marker that appears beside the figure in the text, so a marker reading S4 lands here at S4. Links open on the agency's own website. Where the document states no public URL, none is printed.
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Centers for Medicare & Medicaid Services
https://www.cms.gov/newsroom/fact-sheets/fiscal-year-2025-improper-payments-fact-sheet
Carries the FY2025 improper-payment estimates on the analysis page for Medicare Fee-for-Service, Medicare Part C, Medicare Part D, and Medicaid, and the 77.17% of FY2025 Medicaid improper payments that CMS attributes to insufficient documentation, which CMS says is generally not indicative of fraud or abuse.
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U.S. Department of Justice, Office of Public Affairs
Carries the FY2025 totals used on the homepage, the False Claims Act page, and the analysis page: more than $6.8 billion in False Claims Act settlements and judgments, over $5.7 billion of it in matters involving the health care industry, 1,297 qui tam suits filed, 401 investigations opened, and more than $5.3 billion from qui tam suits filed that year or earlier. It also carries the relator share the Department describes as typically between 15% and 30%. That is a statutory range and a historical description, not a prediction of any result.
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U.S. Department of Justice, Civil Division
https://www.justice.gov/opa/media/1424121/dl
Carries the full-record totals used on the homepage, the False Claims Act page, and the analysis page: $85,652,583,093 in settlements and judgments across FY1987 through FY2025, of which $60,972,925,646 came from qui tam matters.
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HHS Office of Inspector General
No public URL stated in the source document.
Carries the scale and oversight figures on the homepage and the analysis page: more than $1.7 trillion in combined annual Medicare and Medicaid expenditures, coverage of about 40 percent of the U.S. population, and the FY2023 position of more than $2 trillion in HHS expenditures overseen on a final budget of $432.5 million, about two cents for every $100 of HHS spending, by what the testimony described in April 2024 as nearly 1,600 professionals. It also carries the 2019 orthotic brace migration used on the method and analysis pages, where Medicare fee-for-service claims for those braces fell 9 percent and claims for the same braces billed to Medicare Advantage rose 22 percent, and the 59 percent increase in durable medical equipment billing in Medicare Advantage from 2020 to 2023.
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HHS Office of Inspector General
https://oig.hhs.gov/documents/budget/10322/FY%202026%20OIG%20CJ.pdf
Carries three items on the analysis page: a FY2026 request that would support 1,479 full-time equivalents, a reported return of $11 in expected recoveries and receivables for every $1 invested in the office, and the quoted line about the reach of its work being bound only by its resources.
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CMS Center for Program Integrity
No public URL stated in the source document.
Carries the Fraud Prevention System's hundreds of models, cited on the method page and the analysis page, and the calendar-year 2025 program-integrity figures on the analysis page: 7,701 Medicare providers and suppliers investigated for potential fraud, 537 payment suspensions imposed, 5,586 providers and suppliers revoked, and 372 fraud referrals accepted by law enforcement, encompassing $3.7 billion.
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U.S. Government Accountability Office
https://www.gao.gov/products/gao-26-107799
Carries four items on the analysis page: the $11.9 billion in potentially fraudulent Medicare payments CMS estimates it prevented from FY2022 through FY2024 by taking administrative action; the 15 providers who allegedly billed Medicare more than $4 billion for urinary catheters that were never supplied in 2023 and 2024; the at least $196,000 in state and federal cost sharing that state Medicaid agencies paid on that scheme over the same period; and CMS's December 2025 start of sharing Medicare payment-suspension information with supplemental payers.
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U.S. Government Accountability Office
https://www.gao.gov/products/gao-24-107487
Carries three items on the analysis page: Medicare and Medicaid as 26 percent of federal program spending in FY2023, the more than a billion transactions Medicare processed in 2023, and GAO's designation of Medicare as a high-risk program in 1990 and Medicaid in 2003.
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U.S. Government Accountability Office
https://www.gao.gov/products/gao-26-107946
Carries GAO's finding, cited on the analysis page, that CMS has not conducted a comprehensive fraud risk assessment of the Medicare Advantage program and that CMS's corrective action plans for that program are not sufficiently detailed.
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United States Congress
No public URL stated in the source document.
Every statement on this site about what the statute says points here, on the homepage, the False Claims Act page, the method page, and the contact page. Section 3730(h) supplies remedies that a court can award after retaliation has happened. It is not a guarantee that retaliation will not happen, and nothing on this site should be read as one.
How these figures are used
Government reporting is revised. Where a figure is superseded, this page and the page that used it are both updated.
Recoveries reported by the Department of Justice describe past enforcement by the United States. They are not a forecast of results in any matter and they are not results of this firm.
Statements about what the statute itself says are keyed to the statute and explained on the False Claims Act page.
If a figure here does not match what you saw
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