Unmasking Healthcare Fraud Preying on Montana’s Native Americans: A Threat to National Sovereignty and American Families

Montana State Auditor James Brown has exposed a disturbing healthcare fraud operation targeting vulnerable Native American communities on tribal lands. Fraudsters preyed on those most in need—often unhoused or economically disadvantaged—to enroll them in Affordable Care Act (ACA) plans under false promises of free, high-end rehab treatment out-of-state, primarily in California.

This isn’t just an isolated scam; it is a symptom of flawed federal policies and loopholes that undermine the integrity of our healthcare system and burden hardworking American families with rising insurance premiums. As these operators exploited provisions allowing Native Americans to enroll anytime—unlike non-Natives restricted to annual windows—they manipulated protections intended for sovereignty and access into opportunities for deceit.

How Does This Scam Threaten National Interests?

By abusing out-of-state coverage policies held by Montana insurers like PacificSource, which permits billing for services rendered far from Montana, fraudsters have funneled tens of millions in illegitimate claims—$23.3 million clawed back so far, with potential exposure near $55 million. Such unchecked exploitation inflates costs not only for tribes but also for all Montanans and by extension, taxpayers nationwide.

The consequences ripple across the system: when scammers bill exorbitant fees—sometimes over $900,000 per patient—for treatments never delivered or grossly overpriced, insurance providers tighten networks or limit coverage options to protect themselves. That leads directly to reduced access and increased costs for everyday Americans struggling under inflationary pressures.

Why Are Federal Loopholes Enabling This Vulnerability?

• The ACA’s well-meaning provision granting federally recognized tribes year-round enrollment inadvertently opens doors to exploitation by bad actors.
• Insurers’ acceptance of out-of-state care billing creates gaps easily abused by fraudulent treatment centers beyond local oversight.
• The Government Accountability Office recently confirmed weaknesses in eligibility verification processes, famously approving nearly all fictitious applicants they tested—a glaring red flag ignored too long by Washington elites.

Should America allow such systemic failures that sacrifice individual liberty and economic prosperity at the altar of bureaucratic complexity? The answer must be no. Protecting sovereignty means securing tribal interests while safeguarding the broader national health system from costly fraud schemes.

Montana’s experience echoes similar Medicaid fraud cases targeting Indigenous populations elsewhere, underscoring a nationwide pattern demanding urgent federal cooperation. It is encouraging that Missouri’s Auditor Office has engaged FBI and U.S. Attorneys—but meaningful action requires tightening policy guardrails rather than shifting blame.

James Brown’s message is clear: “When scammers bill $10,000 a day in fake enrollments, premiums rise, provider networks shrink, and families pay more for worse care.” This truth hits home for every American who values freedom from government waste and desires stable access to affordable healthcare.

The fight against fraud protects more than just dollars—it defends the principle that public programs should serve their rightful beneficiaries without enabling predators who erode trust in our institutions. How long will Washington tolerate policies that jeopardize our national sovereignty while harming those they claim to help?