🤖 AI Analysis15 min read
The Algorithm Knows
How AI detects Medicare fraud before humans do — and what it means for healthcare oversight
Read More10 years of data. 1.7 million providers. AI-powered fraud detection.
Explore $854.8B in Medicare payments (2014-2023). Our ML model, trained on 8,300+ convicted fraudsters, flagged 500 providers who bill like criminals.
Our AI, trained on 8,300+ confirmed fraudsters, found 500 providers who bill like convicted criminals but haven't been caught. $2.8B in COVID test billing. $5.5B in wound care. 4.6K providers with impossible volumes. See the fraud analysis →
A decade of Medicare spending data at your fingertips
The most striking discoveries from our analysis
One nurse practitioner averaged 413 Medicare services per working day
A Beverly Hills surgeon charges 59 times what Medicare pays for wound care
One eye injection drug costs Medicare more than most agencies' budgets
On average, doctors charge nearly 4 times what Medicare actually pays them
Highest fraud probability scores from our ML model trained on confirmed fraudsters
How AI detects Medicare fraud before humans do — and what it means for healthcare oversight. Our model identified patterns invisible to traditional audits.
Read the InvestigationDeep-dive analysis from our library of 64 data-driven investigations
How AI detects Medicare fraud before humans do — and what it means for healthcare oversight
Read MoreOur AI trained on 8,300+ confirmed fraudsters found 500 providers with identical billing patterns still collecting from Medicare
Read MoreA network of infectious disease providers in Florida billing Medicare millions with suspicious patterns
Read MoreHow three unrelated providers across different states share eerily identical billing fingerprints
Read MoreThe providers collecting the most from Medicare — and what their billing reveals about the system
Read MoreHow the pandemic reshaped Medicare spending, telehealth, and fraud in ways that persist today
Read MoreProviders billing for more services per day than hours in a day — the math doesn't add up
Read MoreHow cancer drugs became Medicare's biggest expense — and who profits from the pipeline
Read MoreDive into Medicare spending from every angle
From AI-powered fraud detection to state-level spending breakdowns — every corner of Medicare, analyzed.
Watchlist, deep dives, impossible billing, wound care schemes
ML model trained on convicted fraudsters flagged 500 active providers
Browse 2,900+ detailed provider profiles with payment histories
Data-driven stories exposing patterns in Medicare spending
Part of the Open Data Network: OpenMedicaid · OpenFeds · OpenSpending
New investigations published regularly. 64 articles and counting.
Last Updated: February 2026 (data through 2023, the latest CMS release)
Note: All data is from publicly available Medicare records. OpenMedicare is an independent journalism project not affiliated with CMS.