2026 Medicaid Fraud News concerning Adult Day Care/Social Day Care Centers

2026 Medicaid Fraud News concerning Adult Day Care/Social Day Care Centers

Following a social media uproar regarding Medicaid fraud involving kickbacks from Adult Day Care Centers (providing money to seniors with Medicaid who are eligible to join the program), the issue arose from overbilling, where the number of seniors does not align with the center's capacity. For example, a center billed for more than 3,000 members, but the actual daily attendance is fewer than 50 people. The major concern is that these seniors are required to attend the Adult Day Care center at least one day per week, with most requesting attendance of 3-4 days per week. The math doesn't add up; for 3,000 members attending at least one day per week, around 400 people should show up each day.

Many centers are limiting new enrollments and preventing outsiders from entering the building. Additionally, some owners are planning to sell their centers. State officials are pressuring insurance plans to monitor this type of fraud, and as a recent measure, the state has sent officers to some centers to enforce lockdowns for investigation.