The HHS Medicaid provider spending dataset covers January 2018 through December 2024, making it possible to track year-over-year changes in billing. Some providers show steady, predictable growth. Others show sudden, dramatic increases that stand out from the crowd.
Here are the providers with the largest absolute spending increases from 2023 to 2024, among those billing more than $10 million in 2023:
Biggest Year-Over-Year Increases
| Provider | Location | 2023 | 2024 | Increase | % Change |
|---|---|---|---|---|---|
| Fishing Point Health Care LLC | Portsmouth, VA | $34M | $135M | +$100M | +288% |
| Call The Car | Pasadena, CA | $175M | $273M | +$98M | +56% |
| Palco, Inc. | Maumelle, AR | $92M | $189M | +$96M | +104% |
| Marks Homecare CDPAP, LLC | Brooklyn, NY | $17M | $102M | +$84M | +499% |
| BHPN, LLC | Walnut Creek, CA | $63M | $118M | +$54M | +84% |
| Freedom Care LLC | New Hyde Park, NY | $758M | $805M | +$47M | +6% |
| Contra Costa County | Martinez, CA | $98M | $143M | +$44M | +45% |
| Consumer Direct Care Network Virginia | Missoula, MT | $477M | $522M | +$44M | +9% |
| Consumer Direct for Tennessee, LLC | Nashville, TN | $41M | $84M | +$42M | +102% |
| Upper Mattaponi Indian Tribe | Aylett, VA | $17M | $57M | +$39M | +228% |
Notable Cases
Fishing Point Health Care LLC — +288% ($34M to $135M)
Fishing Point Health Care in Portsmouth, Virginia saw the largest absolute spending increase of any provider in the dataset, jumping from $34 million in 2023 to $135 million in 2024. The overwhelming majority of their billing is on code S5121 — "chore services per diem" — accounting for $152 million of their all-time total. They serve approximately 5,266 beneficiaries through this code.
Marks Homecare CDPAP — +499% ($17M to $102M)
Marks Homecare CDPAP, LLC in Brooklyn quintupled its billing in a single year. The CDPAP designation — Consumer Directed Personal Assistance Program — puts this squarely in the New York personal care space. Marks Homecare Agency Inc (a separate NPI in Corona, NY) is already a $1.08 billion biller. The CDPAP entity appears to be a newer vehicle for the same operation.
Call The Car — +56% ($175M to $273M)
Call The Car in Pasadena, California is a non-emergency medical transportation (NEMT) provider that added $98 million in billing in a single year. Their top code is A0425 — ground mileage — at $234 million, followed by stretcher van transport and basic life support mileage. NEMT is a documented fraud hotspot in Medicaid; the question is whether this growth reflects expanding legitimate service or something else.
Upper Mattaponi Indian Tribe — +228% ($17M to $57M)
The Upper Mattaponi Indian Tribe in Aylett, Virginia tripled their Medicaid billing, primarily through S5121 (chore services) at $48 million and Q5009 (home health) at $24 million. Tribal health programs often operate under different Medicaid frameworks, which may explain the growth trajectory.
What Drives These Increases?
Rapid growth in Medicaid billing can reflect several things:
- Program expansion: States expanding Medicaid eligibility or adding new covered services
- Entity restructuring: Billing shifting from one NPI to another within the same organization
- Market growth: Legitimate service expansion in underserved areas
- Rate increases: States raising reimbursement rates for certain services
- Fraud: Billing for services not rendered, inflating service hours, or patient fabrication
This data cannot distinguish between these explanations. A 500% increase is not proof of fraud — nor is it proof of innocence. It is, however, exactly the kind of signal that investigators and auditors use to prioritize their reviews.
Explore the Data
Every provider mentioned above has a detailed profile on this site showing their full billing history, monthly trends, and code-level breakdown. Click any provider name to see the complete picture, or browse by state to find the fastest-growing providers in your area.