OKLAHOMA CITY (July 16, 2026) – Attorney General Gentner Drummond announced today that his office has opened an investigation into the Oklahoma Health Care Authority's (OHCA) handling of alleged fraud, waste and abuse within the state's Medicaid managed care program. This new investigation follows recent revelations that OHCA leadership hand-picked by Gov. Stitt failed to report a large-scale, foreign-based enrollment fraud scheme.
“Medicaid exists to protect Oklahoma's most vulnerable residents, not to become a target for international fraud rings,” said Drummond. “When my office is not notified in a timely manner that thousands of fraudulent accounts were opened inside our state's Medicaid program by foreign actors, that's not a paperwork failure. It's a breakdown in OHCA administration.”
Under federal regulation, the state contract can either require Medicaid managed care entities (MCEs) to report suspected fraud to OHCA’s Program Integrity Unit or to the Attorney General’s Medicaid Fraud Control Unit (MFCU). Gov. Stitt and OHCA chose to have suspected fraud reported first to OHCA with the option for them to refer cases to the Attorney General’s office, potentially resulting in countless cases going uninvestigated.
Gov. Stitt’s administration and his leadership team at OHCA failed, sending only two of MCFU’s 168 fraud referrals in Fiscal Year 2025. Of the 509 fraud referrals received by MFCU during FYs 2022–2024, only 11 originated from OHCA.
“My office has continuously called on OHCA to review its controls, increase referrals, inform my office about unclean claims or fraudulent activity,” Drummond said.
Today’s investigation comes after Drummond's office learned that a criminal group believed to originate from a foreign country exploited weaknesses in OHCA's eligibility process during open enrollment, potentially allowing thousands of fraudulent Medicaid enrollments into the program. All three of the state's managed care entities are reportedly affected.
None of this suspicious activity had been reported to the Attorney General's office by OHCA.
The revelation follows numerous warnings from Drummond to OHCA leadership. Most recently, in a March 26 letter, Drummond pressed the authority on persistent provider complaints about payment delays and claims denials, writing that "if unclean claims or fraud are contributing to these failures, identify them and act. But inaction — for any reason — is reckless and unconscionable." OHCA's April 10 response detailed claims-processing and prior authorization statistics but did not address fraud.
“OHCA was armed with all the tools they needed to fight fraud. Instead, it stayed silent while thousands of suspected fraudulent Medicaid enrollments went unreported,” said Drummond. “Oklahomans expect their Medicaid dollars to protect vulnerable patients, not to fund an organized fraud operation that nobody at OHCA thought to bring to the attention of law enforcement.”
This investigation builds on Drummond's April request for an audit of OHCA through the Office of the State Auditor and Inspector.
Oklahomans who received a Medicaid enrollment packet they did not request may have had their identity used as part of this scheme. Individuals who believe they were affected are encouraged to submit an online Medicaid Enrollment Fraud Report. Reporting does not mean a person is under investigation. The reports help the Attorney General's office identify victims and gather more information.
