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25 Investigates: $10.6M in benefits fraud, little clawed back

BOSTON — More than $10.6 million in tax dollars intended to help people in need across Massachusetts ended up in the hands of fraudsters during the first six months of 2026, according to a new report released Wednesday by State Auditor Diana DiZoglio’s office.

State agencies have recovered just $285,339 of that amount, according to the report.

The findings come from the Auditor’s Bureau of Special Investigations (BSI) and cover the third and fourth quarters of Fiscal Year 2026 (Jan. 1 through June 30, 2026). Out of 2,223 cases investigated across six regional offices, examiners confirmed fraudulent overpayments in 402 cases.

The state’s MassHealth Medicaid program saw the largest share of fraudulent activity, accounting for 57% of the stolen money.

MassHealth/Medicaid: $6,051,185 (57.0%)Supplemental Nutrition Assistance Program (SNAP): $3,854,119 (36.3%)Personal Care Attendant (PCA) Services: $538,332 (5.1%)Transitional Aid to Families with Dependent Children (TAFDC): $130,483 (1.2%)Emergency Aid to the Elderly, Disabled, and Children (EAEDC): $38,463 (0.4%)

The report doesn’t name any of the suspected fraudsters, but investigators highlighted two “dental providers” found to be billing MassHealth for “impossible days” when their offices were closed.

The $10.6 million figure marks a sharp surge in identified fraud compared to the $4.4 million uncovered in the previous six-month reporting period.

In an interview with 25 Investigates, Auditor DiZoglio emphasized the importance of public tips to her office, noting that referrals coming directly from state agencies that administer the programs have declined compared to prior state administrations.

“Under this administration, we haven’t seen as many referrals, which actually makes it so that we can’t look into those cases as often as we used to be able to,” DiZoglio told 25 Investigates, pointing specifically to childcare voucher programs.

“When people commit fraud, they are robbing from people who are truly in need,” DiZoglio said. “Those social safety net programs exist to help families who might be struggling for a period of time to get from one point to the next.”

The report reveals that out of the $10.6 million in fraud identified between January and June, only $285,339 in civil recoveries and restitution settlements has been finalized so far.

The auditor lacks law enforcement authority to prosecute fraud or collect restitution. That responsibility falls to state agencies.

“When we have $10.6 million being identified, that demonstrates the obvious need for improvement in oversight regarding these programs to ensure that the state coffers are not bleeding out to these fraudulent activities,” DiZoglio said. “Restitution settlements are ongoing and continue beyond the issuance of this report,” the document states.

A spokesperson for the Executive Office of Health and Human Services (EOHHS) pushed back in a written statement to 25 Investigates:

“Most of these cases were identified and reported to the Auditor’s office by our agencies. We have strong program integrity processes in place to detect fraud and abuse, and we take immediate action.”

Regarding criminal prosecutions and clawbacks, EOHHS wrote that the responsibility lies with the Auditor’s office, stating that BSI is responsible for investigating referrals and determining which cases are passed along for prosecution.

The BSI report states, “Our governing statute does not authorize BSI to collect settlement payments of any kind; the individual benefit programs are responsible for collection activities related to BSI cases.”

If you suspect public assistance fraud in Massachusetts, you can submit an anonymous report to the State Auditor’s Bureau of Special Investigations online at mass.gov/auditor or by calling the BSI hotline at (617) 727-6771.

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