The Trump administration will require all states to launch audits of Medicaid providers following months of scandals involving hundreds of millions in fraud and waste in the program.
Centers for Medicare & Medicaid Services Administrator Dr. Mehmet Oz announced Tuesday that his agency would request plans from all 50 states to conduct reevaluations of their Medicaid providers, to be submitted within the next 30 days.
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Medicaid, the state-administered, partially federally funded health insurance program for low-income Americans, covers roughly 70 million adults and children.
The program also covers a variety of services not traditionally covered by other types of insurance, such as home health or nursing homes, special needs care, and hospice.
Oz said during the Politico Health Summit that CMS will request plans for how states plan to “revalidate providers in high-risk areas in their states.” The administrator stressed that his agency would work with states so as not to disrupt access to care for enrollees.
“Give us your strategy of how you’re going to do it,” Oz said. “I know this takes time and effort, and so we’re not just [going to] throw it out there and blow everything up. I want you to recognize how precious Medicaid is.”
Identifying waste, fraud, and abuse in healthcare entitlement programs, including Medicaid and Medicare for seniors, has been a central theme of the Trump administration’s approach to lowering overall government healthcare spending.
During several budget appropriations hearings in Congress this week, Health and Human Services Secretary Robert F. Kennedy Jr. accused the Biden administration of shutting down program integrity units for health entitlement programs.
The nationwide audit comes after multiple Democrat-led states have been the subject of fraud investigations into health services programs covered by Medicaid, such as autism care centers in Minnesota and home health aides in New York state.
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A Washington Examiner analysis of Medicaid spending in February found dozens of states across the country gave more than $380 million to medical providers who were later caught defrauding the program.
Ohio, Arizona, Nevada, Kentucky, and New York were the five worst offenders, according to that analysis.
Last week, Vice President JD Vance’s anti-fraud task force suspended more than 450 hospice centers and home health agencies in Los Angeles that allegedly defrauded Medicaid of more than $600 million.
Oz said during the Politico interview that the new initiative sought to identify fraud in every single state, not just those led by Democratic administrations.
“I’ve heard this complaint from red and blue governors. They care about these programs as well,” Oz said. “They don’t want widespread fraud, but oftentimes they’re not quite sure how to get their arms around it.”
But Oz also said that the administration may have to take tougher actions if states are not “serious about this.”
“If you don’t take it seriously, it indicates to us that we might have to take the audits that we’re doing to the different states more aggressively,” Oz said.
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Sen. Ed Markey (D-MA), who spoke at the Politico event immediately after Oz’s interview, criticized the new initiative by saying the administration is “just trying to distract” from other issues.
“You’d have to have an aquarium to have all the red herrings that they put out there,” said Markey. “We have the grifter in chief in the White House, and somehow or other, again, it’s just to distract from the central corruption which is now taking place in our country, which is coming right out of the cronyism in the White House.”
