Vice President JD Vance sharply criticized Hawaii’s record on Medicaid fraud in mid-May, saying the state had produced zero convictions for fraud over the preceding four years. “If you’re committing fraud in Medicaid in Hawaiʻi, at least up until now, you’ve had effectively free rein from the government of Hawaii to commit as much fraud as you want,” Vance said.
Hawaii Attorney General Anne Lopez and the director of the state’s anti-fraud unit responded by pointing to $14 million in settlements the unit had secured. In a statement, Lopez said, “We welcome accountability, but we will not allow the work of this unit to be mischaracterized as doing nothing.”
But an examination of the state’s record, reported by Honolulu Civil Beat via the Associated Press, shows that the bulk of that figure — approximately $13 million — came from a single case that settled in 2023 but was initiated more than a decade ago. The remaining $1 million came from other settlements over the four-year period.
The exchange, which took place against the backdrop of a nationwide Trump administration push to tighten Medicaid oversight, underscores the gap between the dollar-value of settlements and the number of actual convictions. Vance, who has led a series of high-profile fraud enforcement actions since taking office, has focused attention on states with low conviction numbers. MSI previously reported on his targeting of Ohio and Minnesota over similar concerns.
Lopez’s office has not provided a breakdown of how many cases the unit has opened, closed, or referred for prosecution during the period in question. The state has also not said whether the zero-conviction figure reflects cases that did not result in charges or cases that were still under investigation.
The Trump administration has escalated its scrutiny of Medicaid fraud across multiple states in recent months, including pauses to some funding for Minnesota and New York, expansions of probes in Florida, and the creation of a new DOJ fraud enforcement division.