Saritha Komatireddy, a Republican running for New York attorney general, is centering her campaign on a promise to revive aggressive Medicaid fraud enforcement, saying prosecutions have cratered under incumbent Letitia James and taxpayers are paying the price. Komatireddy points to falling recoveries, rising program costs, and federal scrutiny as evidence that New York can and must do better on fraud detection and prosecution.
Komatireddy is hammering home one clear point: the state used to bring in big Medicaid recoveries and convictions, and that muscle has weakened. She argues this decline has real consequences for New Yorkers, who see higher healthcare costs and fewer resources for other priorities when fraud goes unpunished. The campaign frames the issue as straightforward accountability rather than partisan theater, focusing on results and recovered dollars.
Komatireddy says the numbers tell the story, noting a steep drop in recoveries from the early years of the current administration to recent filings. She highlights a fall from $168 million in 2019 to roughly $31 million in 2024 as a warning sign that the office is not prioritizing fraud recovery the way prior administrations did. Those prior administrations, she says, routinely posted much larger annual recoveries that helped fund state services without new taxes.
“They’re totally failing to prosecute Medicaid fraud, and you can look at that based solely on the record of Letitia James and her Democratic predecessors,” Komatireddy said. Her point is that the decline is visible in official reports and that restoring enforcement is a practical, measurable way to protect taxpayers. That message plays to voters tired of seeing waste and want elected officials who deliver results.
Komatireddy also points out that spending on the fraud recovery program has actually increased even as recoveries fell, creating a troubling mismatch. Program costs rose from roughly $45 million in fiscal 2020 to about $70 million in 2025, she notes, which raises questions about efficiency and priorities inside the attorney general’s office. From her perspective, more spending should yield more recoveries, not fewer.
“Even her Democratic predecessors used to bring in $200 to $300 million per year in fraudulent proceeds,” Komatireddy said. “When Tish James comes into office, it goes down to $20 to $30 million per year. According to her own year-end reports, she’s just decided not to do that part of the job.” Those lines are meant to underline a contrast in approach and outcomes that Komatireddy thinks voters should weigh carefully.
Beyond dollar figures, Komatireddy highlights criminal convictions as a key measure of enforcement vigor. “It used to be the case the New York Attorney General’s office would get around 100 criminal convictions a year, holding people who are stealing from Medicaid accountable,” Komatireddy said. “Under Tish James, that number is very low. There’s one year where she got eight criminal convictions.”
Federal officials have also taken notice, prompting a review of how New York screens providers and fights fraud. Centers for Medicare & Medicaid Services inquiries are rare and signal real concern, Komatireddy argues, and she sees that federal attention as validation of her campaign’s priorities. She frames stronger enforcement as both a consumer protection and a fiscal necessity.
“It’s New Yorkers who pay the price, because when people steal from Medicaid, that increases our healthcare costs,” she said. “When we are just letting a billion dollars go out the door over the course of her term, that’s money that we could be getting back as taxpayers.” Komatireddy uses that language to connect fraud enforcement directly to everyday bills and state budgeting choices.
Her solution is blunt and narrow: beef up the Medicaid Fraud Control Unit with more prosecutors and a return to results-driven enforcement. Komatireddy pledged to add 20 criminal prosecutors to restore capacity and recoveries, arguing a law enforcement background matters for an attorney general. A former federal prosecutor who worked in the U.S. Attorney’s Office and at the Drug Enforcement Administration, she frames the race as a contrast between career law enforcement experience and what she calls an incumbent who has deprioritized prosecutions.
“The folks in Albany keep thinking of new ways to take more money away from taxpayers,” she said. “If you had an attorney general who actually prosecuted fraud properly, you wouldn’t have to worry about a tax hike.” That closing pitch is aimed at voters who want officials who reduce waste and hold wrongdoers accountable.
