Because healthcare fraud is not new, the Justice Department has had a dedicated healthcare fraud unit for nearly two decades. But the COVID-19 pandemic and the healthcare lies that enveloped it have created new vulnerabilities in Medicare and Medicaid. Vice President JD Vance has made healthcare a central focus of the Trump administration’s anti-fraud agenda. Democrats should work with Vance but instead are reflexively treating every enforcement action as a partisan attack.
Medicare and Medicaid have always been vulnerable to fraud because they are huge, fast-paying systems in which third parties get money directly for providing services that are often difficult to document. The pandemic made the problem worse because Washington loosened its rules, moved fast, and relied heavily on remote verification. That was understandable in an emergency, but it also created many opportunities for criminals. Telehealth, home health, hospice, laboratory billing, durable medical equipment, addiction treatment, and Medicaid waiver programs became attractive targets for crooks. The Department of Health and Human Services inspector general found 1,714 Medicare telehealth providers whose billing during the first pandemic year posed a high risk for fraud, waste, or abuse.
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Some states run by Democrats, including California and Minnesota, have also pushed Medicaid dollars into nontraditional services such as housing, food, utilities, and home-based supports. Some of these programs may have merit. But when government pays for services that are harder to verify than a doctor’s visit or hospital stay, fraud prevention must be stronger, not weaker. These programs became a magnet for fraudsters, particularly in Minnesota, where 15 people were recently charged with stealing more than $90 million from Medicaid-related programs. California has also been a hot spot for fraud, with a 2022 state auditor report finding that the number of hospice agencies in Los Angeles County alone grew 1,500% over the past decade. The auditor concluded that the state’s “weak controls have created the opportunity for large-scale fraud and abuse.”
Healthcare fraud is not only a taxpayer concern, though taxpayers have every right to be angry that their money is being stolen. It is also a direct threat to elderly, poor, and disabled people. Patients who need urgent care can be denied services or have them delayed if government records falsely show they are already receiving care elsewhere. A senior citizen who needs hip surgery, for example, may have treatment postponed because fraudulent billing records say he is enrolled in hospice care elsewhere.
That is why Vance’s Task Force to Eliminate Fraud is so important. It did not invent healthcare fraud enforcement — the DOJ and the HHS Office of Inspector General have been doing that work for years. What Vance has done is force a whole-government response. The task force has coordinated the DOJ, HHS, the Centers for Medicare and Medicaid Services, inspectors general, and state-facing enforcement. It has helped push a nationwide review of state Medicaid Fraud Control Units. It has backed a six-month freeze on new Medicare enrollments for home health and hospice providers. It has supported the DOJ’s new National Fraud Enforcement Division and HHS’s artificial intelligence-assisted audit initiative, which will review years of audit records across all 50 states.
Anti-fraud enforcement should not become an excuse to deny legitimate care or bury honest providers in paperwork. But that is an argument for smarter oversight, not for lax anti-fraud enforcement.
Democrats should welcome this work, but many have treated it as a partisan attack, which probably says much about their guilty consciences. Gov. Tim Walz (D-MN) denounced the administration’s Medicaid funding pause as political retaliation. California officials have disputed the administration’s decision to defer $1.3 billion in Medicaid reimbursements rather than acknowledge the obvious fraud vulnerabilities in their own hospice system. The latest example came last week, when several Democratic attorneys general declined Vance’s invitation to attend a White House task force meeting on fraud. This obstruction is unacceptable.
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There is no Democratic or Republican constituency for letting criminals steal taxpayer dollars. Fraud hurts taxpayers, patients, honest providers, and the credibility of the safety net itself. Democrats should care about fraud because its prevalence undermines support and further funding of the programs they cherish.
Vance should keep pressing states to prove that their Medicaid Fraud Control Units are doing their jobs. Democrats, in turn, should insist that enforcement be accurate and fair, and protect legitimate care, but they should stop treating anti-fraud work as a Trump plot. Protecting Medicare and Medicaid from criminals is not a partisan favor to Vance. It is a public duty.
