Officials Warn About Potential ACA Fraud

Nevada officials are urging vigilance after a $54.7 million health care fraud scheme was uncovered in Montana, raising concerns that similar tactics could emerge in the Silver State.

In January 2026, Montana State Auditor and Commissioner of Insurance James Brown announced the dismantling of a large-scale Affordable Care Act (ACA) fraud operation that targeted Native American communities on reservations. The scheme involved unlicensed insurance agents and so-called “body brokers” who encouraged individuals to leave Medicaid for ACA marketplace plans.

Agents sent several Tribal members to out-of-state substance abuse treatment centers that provided little or no legitimate care, with insurers billed up to $9,000 per day for up to 90 days. Montana investigators reviewed 207 suspicious enrollments, securing $23.3 million in savings and halting further fraudulent payments.

While no similar schemes in Nevada are confirmed, state regulators and tribal advocates are cautioning residents to watch for warning signs, including aggressive recruitment in tribal communities, offers of out-of-state addiction treatment, and pressure to disenroll from Medicaid.

Residents should report suspicious activity to the Nevada Division of Insurance Consumer Services, the Attorney General’s Bureau of Consumer Protection, or the HHS Office of Inspector General.