Winslow Indian Health Care Center Billing Medicaid 7-14X Over National Averages

Audit reveals massive overpayments to Native American health clinic for routine office visits

Published on Feb. 27, 2026

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A new analysis of Medicaid data has uncovered concerning billing practices at the Winslow Indian Health Care Center (WIHCC) in Arizona, where the clinic appears to be charging Medicaid 7 to 14 times the national average reimbursement rates for routine office visits. The data shows WIHCC billed Medicaid $120.8 million for 227,200 visits coded as the higher-level 99213 office visit, which typically requires a minimum of 20 minutes of face time with a physician. However, experts estimate that the clinic would need an impossibly high number of physicians working non-stop to actually provide that level of service to justify the billing.

Why it matters

The findings raise serious questions about potential Medicaid fraud and abuse at WIHCC, which serves the local Navajo population. If the clinic is indeed overbilling Medicaid for office visits that do not reflect the actual time spent with patients, it could be depriving critical healthcare funding from the Native American community it is meant to serve. The high reimbursement rates also suggest the potential for a sweetheart deal or other improper arrangement between the clinic and Medicaid authorities.

The details

The analysis focused on just the 99213 office visit code, which WIHCC billed Medicaid an average of $531.60 per claim. In comparison, the national average reimbursement rate for a 99213 visit is typically around $75-$100. Experts estimate that to provide 227,200 visits lasting a minimum of 20 minutes each, the clinic would require the equivalent of 5 full-time physicians working non-stop with no breaks or vacations. The high volume and reimbursement rates raise red flags about potential upcoding and overbilling practices at the clinic.

  • The Medicaid data analyzed covers claims from 2026.

The players

Winslow Indian Health Care Center (WIHCC)

A healthcare clinic serving the local Navajo population in Winslow, Arizona.

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What’s next

Authorities are expected to launch a full audit of WIHCC's Medicaid billing practices to determine the extent of any potential fraud or abuse.

The takeaway

This case highlights the need for rigorous oversight and auditing of Medicaid payments, especially to providers serving vulnerable populations, to ensure critical healthcare funding is not being siphoned off through improper billing practices.