The Commissioner of Securities and Insurance Office in Montana has helped to stop a multimillion-dollar billing scheme that targeted Native Americans on reservations. The scheme, which involved fraudulent claims through the Affordable Care Act, resulted in over $23.3 million in unjustified claims, with an additional $27 million pending. Commissioner James Brown announced that the investigation, which was conducted in cooperation with health insurers, tribal communities, and law enforcement, has led to the identification of at least 183 victims.<\/p>\n
The scheme involved agents who preyed on vulnerable Native Americans, enticing them to disenroll from Medicaid and sign up for health insurance through the Affordable Care Act. The agents would then transport the victims to California, where they would be kept for 90 days and provided with “fake services.” The insurance company would then be billed $9,000 a day for 90 days, resulting in fraudulent claims of over $800,000 per person.<\/p>\n
Brown described the scheme as “reprehensible” and stated that the victims were often exploited, coerced, and left stranded in California without a way to return home. He also noted that some victims have yet to be found. The investigation found that the agents used falsified records, unlicensed and out-of-state actors, and fabricated addresses to obtain coverage.<\/p>\n
The Commissioner’s office worked with PacificSource, a nonprofit health insurance provider, to identify the suspicious activity and launch an investigation. The investigation supported the ability of the Centers for Medicare and Medicaid Services to approve the non-payment of fraudulent claims and rescind the policies. Brown praised the work of his team, stating that they have “zero tolerance for fraud” and are focused on consumer protection.<\/p>\n
The scheme is not limited to Montana, with Arizona and Alaska also reporting similar incidents. Brown has alerted his counterparts and insurance providers in Washington and Wyoming to the scheme, warning that any state with a significant Native American population is a target. The Commissioner’s office is helping to re-enroll victims into Medicaid and is pursuing additional investigations. Brown encouraged Montanans to be wary of any agents advising disenrollment in Medicaid and recommending treatment programs in California through the Affordable Care Act.<\/p>\n","protected":false},"excerpt":{"rendered":"
The Commissioner of Securities and Insurance Office in Montana has helped to stop a multimillion-dollar billing scheme that targeted Native Americans on reservations. The scheme, which involved fraudulent claims through the Affordable Care Act, resulted in over $23.3 million in unjustified claims, with an additional $27 million pending. Commissioner James Brown announced that the investigation, […]<\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"","ping_status":"","sticky":false,"template":"","format":"standard","meta":{"_et_pb_use_builder":"","_et_pb_old_content":"","_et_gb_content_width":"","jetpack_post_was_ever_published":false,"_jetpack_newsletter_access":"","_jetpack_dont_email_post_to_subs":false,"_jetpack_newsletter_tier_id":0,"_jetpack_memberships_contains_paywalled_content":false,"fifu_image_url":"","fifu_image_alt":"","_jetpack_memberships_contains_paid_content":false,"footnotes":""},"categories":[31,22],"tags":[],"class_list":["post-222746","post","type-post","status-publish","format-standard","hentry","category-care","category-insurance"],"jetpack_featured_media_url":"","jetpack_shortlink":"https:\/\/wp.me\/p9ibIB-VWG","jetpack_sharing_enabled":true,"jetpack-related-posts":[{"id":222658,"url":"https:\/\/smallnews.in\/insurance\/2026\/01\/13\/whitehouse-slotkin-and-schakowsky-have-introduced-a-public-health-insurance-option-for-the-affordable-care-act\/","url_meta":{"origin":222746,"position":0},"title":"Whitehouse, Slotkin, and Schakowsky have introduced a public health insurance option for the Affordable Care Act.","author":"Team Small News","date":"January 13, 2026","format":false,"excerpt":"US Senators Sheldon Whitehouse and Elissa Slotkin, along with Congresswoman Jan Schakowsky, have introduced the Affordable Consumer Health Options and Insurance Competition Enhancement (CHOICE) Act. 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