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by WILL FOLKS
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South Carolina attorney general Alan Wilson is leading a nationwide coalition of states petitioning the federal government for expanded authority to prosecute Medicaid fraud.
Wilson, the Palmetto State’s GOP gubernatorial nominee, was the author of a letter submitted to congressional leaders on Monday (August 3, 2026) urging them to pass the proposed STOP Fraud in Medicaid Act. Enactment of this legislation would empower states to “address fraud at every level of the program — not just among providers, but also among those who would unlawfully exploit the system for personal gain,” Wilson contended.
Currently, federal restrictions on state Medicaid fraud units confine these entities to the investigation and prosecution of Medicaid provider fraud. The proposed legislation endorsed by Wilson would enable them to investigate and prosecute beneficiary and recipient fraud as well.
“Medicaid is a shared state and federal responsibility,” Wilson wrote in the letter (.pdf), which was undersigned by the attorneys general of sixteen other states. “When fraud goes unchecked, it drains resources meant for those truly in need and undermines public confidence in the program. This legislation provides a common-sense solution that enhances our ability to fully protect the public treasury and ensure that every dollar spent in the Medicaid program is used appropriately.”
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According to a news release from Wilson’s office, he penned the letter because South Carolina is “one of the only states with a dedicated state-level Medicaid Recipient Fraud Unit that focuses on both investigation and prosecution of Medicaid Beneficiary Fraud.”
“We have just begun to see the uncovering of massive fraud in multiple sectors across the United States,” Wilson said. “Medicaid fraud is robbing from some of our most vulnerable citizens. It’s time for Congress to give every state the resources it needs to prosecute Medicaid recipient fraud.”
Wilson has made fighting Medicaid fraud one of the top priorities of his tenure as attorney general. The issue is also very much on the radar of the man most likely to replace him as South Carolina’s top prosecutor in 2027 (Wilson is not seeking a fifth term as attorney general, choosing instead to campaign for governor).
As we reported earlier this year, S.C. eighth circuit solicitor David Stumbo – the GOP nominee for attorney general in the fall election – previously pledged his support for state level Medicaid fraud prevention legislation.
“As attorney general, I’m going to stop it,” Stumbo said.
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RELATED | S.C. PROSECUTOR ZEROES IN ON MEDICAID FRAUD
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According to the latest data from the U.S. Centers for Medicare and Medicaid Services (CMS), the current “estimated improper payment rate” for Medicaid is 6.12% (or $37.39 billion) – up considerably from 5.09% ($31.1 billion) the previous year. The government claims 77.17% of improper payments in the latest data cycle are attributable to “insufficient documentation,” however – which it insists is “generally not indicative of fraud or abuse.”
Those numbers are viewed with skepticism, however.
According to a March 2025 report prepared by Brian Blase and Rachel Greszler of the Paragon Health Institute, “the true amount of improper payments in Medicaid is twice as high as reported.”
“CMS did not even check if the individuals that states enrolled in Medicaid — and on whose behalf payments were made — were even eligible for Medicaid,” Blase and Greszler noted in their report. “This resulted in hundreds of billions of dollars in improper payments not being counted as such.”
Wilson’s letter urged congressional leaders to “move this common-sense legislation toward a floor vote and enact it into law,” citing the importance of making sure “states have the tools necessary to combat fraud and safeguard this essential program.”
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THE LETTER…
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ABOUT THE AUTHOR…
Will Folks is the founding editor of the news outlet you are currently reading. Prior to founding FITSNews, he served as press secretary to the governor of South Carolina. He lives in the Midlands region of the state with his wife and eight children.
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