Finding Fraud in $1 Trillion of Medicaid Data with DuckDB

Sat, 14 Feb 2026 00:00:00 +0000

CMS recently published provider-level Medicaid spending data from T-MSIS — every fee-for-service, managed care, and CHIP claim from 2018 through 2024, aggregated by billing provider, procedure code, and month. 227 million rows. $1.09 trillion in payments. I wanted to see what falls out when you run some basic fraud heuristics against it.

Data on Rusty Bower

Finding Fraud in $1 Trillion of Medicaid Data with DuckDB