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Deep Dives

Data-driven investigations into federal spending, healthcare, and public records.

April 28, 2026

Pay Per Diagnosis

Medicare pays private insurers more when their members are sicker. So insurers got very good at finding diseases, to the tune of $84 billion in 2025 alone.

$84 Billion

MedPAC's projected 2025 Medicare Advantage overpayment relative to traditional fee-for-service Medicare, about 20% above what the same beneficiaries would have cost if the government had covered them...

April 27, 2026

The $668 Million Group Therapy Code

An obscure Medicaid billing line, a tribal-funding exemption, and a "by-report" pricing rule converted Arizona's behavioral health system into the largest Medicaid loss in state history. This is a story about an HCPCS code.

$53M → $668M

AHCCCS American Indian Health Program outpatient behavioral health spending, FY2019 → FY2022, a 12.6× increase in three years

April 24, 2026

The $250 Million Shell Game

How Chinese exporters keep laundering tariffs through Mexico and Vietnam — and what the 2025 enforcement binge actually caught.

$400 Million

Chinese-origin duty evasion uncovered by CBP in the first six months of 2025 — including the largest single EAPA case in the program's history.

April 22, 2026

The Cheek Swab That Ate Medicare

Medicare's lab-test bill for 2024 was smaller than 2019's by volume, but genetic tests now make up 43% of it — up from 18% in 2018. That's partly real medicine, and partly because a small group of people figured out that Medicare would pay four figures for a Q-tip.

18%

Genetic tests as a share of Medicare Part B laboratory spending, 2018 vs. 2024 — a shift worth roughly $2.2 billion while the lab-using Medicare population

April 21, 2026

The 2,158-Mile Day

Medicaid's non-emergency medical transportation benefit is small, invisible, and structurally prone to fraud. In 2025 and 2026, state attorneys general finally started enforcing like they meant it.

$13M in one day

New York Attorney General Letitia James secured $13 million in settlements from 16 transportation companies — and sued seven more — in a single announcement on June 30, 2025.

April 20, 2026

Medicare's $536 Million Subscription

Medicare spent fifteen million dollars on remote patient monitoring in 2019. It spent five hundred and thirty-six million in 2024. HHS-OIG has now published the audit metrics. There has been exactly one RPM-specific False Claims Act settlement.

$15M → $536M

Medicare Part B spending on remote patient monitoring, 2019 → 2024 — a 36-fold increase, per HHS-OIG's August 2025 Data Snapshot

April 18, 2026

The A4353 Catheter Fraud: How a $3 Billion Medicare Scheme Exposed DMEPOS Oversight Failures

A transnational ring, seven shell companies, one lightly-scrutinized HCPCS code, and a federal fraud-detection system that only worked because accountable care organizations did its job for it.

$153M → $3.1B

Medicare Part B spending on urinary catheter codes A4352 and A4353, 2021 → 2023. Seven shell companies drove the vast majority of the surge.

April 16, 2026

The $54 Million Paper Trail

How tariff evasion went from paperwork violation to DOJ's #2 criminal priority — and why the biggest wave of enforcement hasn't even started yet.

$54.4M

Largest customs fraud FCA settlement in history — Ceratizit USA, December 2025.

April 15, 2026

The 89-Hospice Building

Medicare hospice has quietly become a $28 billion-a-year program, and a startling share of it flows through a stretch of the San Fernando Valley where one office plaza is the registered address of 89 different hospice companies.

109 → 1,841

Licensed hospice agencies in Los Angeles County,

April 14, 2026

The $10 Billion Band-Aid

Medicare spent more on skin substitutes in 2024 than on almost any drug in its formulary. Most of the products have no clinical trials. Some were applied to dying hospice patients by untrained sales reps.

$256M → $10.2B

Medicare Part B spending on skin substitutes, 2019 → 2024 — a