Maryland Health Watchdog Flags $41.9 Million in Questionable Payments Following 1,400: What we know so far

Maryland’s Office of the Inspector General for Health has flagged nearly $41.9 million in payments for potential recovery following 1,422 audits and investigations conducted between fiscal years 2023 and 2025. The findings span Medicaid cases, private health providers, and local health departments statewide. Until recently, the public had no routine access to the underlying reports — a situation that began changing after a legislative audit in September 2026 pushed the agency toward greater transparency.

State auditors examined the inspector general’s office covering the period from July 1, 2022, through April 30, 2026 — the first such evaluation since the agency gained independent status. The office is responsible for auditing local health departments and certain private providers that receive state health grants, as well as investigating suspected fraud, waste, and abuse tied to Maryland health funds. Its caseload grew dramatically over the review period, with investigations rising from 190 in fiscal 2023 to 399 in 2024 and 780 in 2025. Dollars identified for recovery swung from $10.2 million to $5 million before surging to $26.7 million in 2025 alone. The office ran on a budget of $5.8 million in fiscal 2025, with most of that covering salaries and benefits. Staffing remained a persistent challenge: as of June 30, 2025, nine of 39 positions — roughly 23 percent — sat vacant, a gap legislative auditors said may have slowed the timely release of reports. Of the 317 reportable findings from audits of Maryland’s 24 local health departments, 134 were repeat problems, putting the statewide recurrence rate at 42 percent. Baltimore City and Prince George’s County each recorded repeat rates of 100 percent, while five other counties had none.

The $41.9 million figure does not represent confirmed fraud. It reflects amounts the inspector general identified as questionable after audits and investigations — the Maryland Department of Health ultimately determines whether providers or local agencies must repay funds, and the agency’s own reporting acknowledges that portions of identified overpayments have historically been forgiven, adjusted, or appealed.

Of the broader $41.9 million, only about $6 million is detailed in 20 reports now posted on the inspector general’s new public website, which launched in August 2026. Providers account for $4.3 million of that amount across 13 separate organizations, many offering behavioral health and developmental disability services, with auditors citing weak financial records and unreturned duplicate payments. Local health departments account for roughly $1.7 million, with individual findings ranging from $63 in Frederick County to more than $1.5 million in Dorchester County. The remainder of the $41.9 million falls outside the published reports because many investigations involve medical records, personal data, or active law enforcement matters that cannot legally be disclosed. Residents seeking additional records may still file requests under Maryland’s Public Information Act, which allows officials to review and redact protected material before release. Legislative auditors made one formal recommendation — that the office publish audit and investigation results whenever legally permissible — and the inspector general agreed, moving forward with the new online portal as its primary disclosure tool.