Hawaii's attorney general stands to lose around $3 million in federal ‌funding to fight Medicaid fraud after failing to consistently bring criminal cases, the Trump administration said on Thursday, in an escalation of Vice President JD Vance's campaign against healthcare fraud.

The U.S. Department of Health and Human Services Inspector General March Bell sent a ‌letter to Hawaii Attorney General Anne Lopez informing her that her ​state's Medicaid Fraud Control Unit, a body that investigates and prosecutes fraud by healthcare providers, has been denied federal certification.

⁠HHS will no longer fund the unit, which has been receiving around $3 million ​annually, Bell wrote. Without a federally certified Medicaid fraud unit, the state's broader Medicaid ⁠funding could be in jeopardy.

Hawaii's unit obtained no criminal indictments or convictions for Medicaid fraud or patient abuse and neglect between 2022 and 2025, despite increased enrollment in the program, ‌Bell wrote. The state can ask for reconsideration, according to the ​letter.

The move is ‌part of a broader Trump administration push on Medicaid fraud enforcement. Vance accused Hawaii last month ‌of giving fraudsters "free rein," and warned of consequences for states failing to effectively police the program. "If we continue to find problems, we can turn off other ⁠resources within their state Medicaid programs ‌as well. Our goal ⁠here is not to do that," he said at the time.

More than 360,000 Hawaii residents ⁠are ⁠enrolled in Medicaid, the health program for low-income Americans. Hawaii received $2.2 billion in federal Medicaid funds in ‌2024, according to the agency that advises Congress on healthcare spending.

Nationwide, Medicaid fraud units were responsible for more than 4,800 criminal convictions of people and businesses ‌between 2022 ​and 2025, according to the ‌same agency.

Attorney General Lopez has pushed back against the Trump administration's characterization. She has previously said the state has not ignored Medicaid fraud, pointing ​to $14 million recovered in civil cases since 2021. The state also charged two people with criminal healthcare fraud earlier this year.