NEW YORK (AP) — The Trump administration will require all 50 states to explain their plans to revalidate some of their Medicaid providers in a national escalation of anti-fraud efforts that have so far largely focused on specific states, Dr. Mehmet Oz said Tuesday.
The Centers for Medicare and Medicaid Administrator said during a Politico health care summit that his agency plans to ask states to “own” the problem of health care fraud this week with
requests for states to share their strategies within 30 days.
“It's an example of what we'd like them to do to prove that they're serious about this,” Oz said onstage Tuesday. “And 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,” he said, without elaborating.
Tuesday's announcement is part of a federal campaign to tackle waste, fraud and abuse in federal Medicaid and Medicare programs that so far has mostly targeted Democratic states — and at least once has erred in its accusations.
Earlier this month, The Associated Press reported that CMS made a significant error in figures it used to help justify a fraud probe in New York. The acknowledgment deepened doubts in the administration's methods and raised a common criticism that has been made about the second Trump administration — that it tends to attack first and confirm the facts later.
In addition to New York, CMS has approached at least four other states with investigations into potential health care fraud and halted some $243 million in Medicaid payments to one of them, Minnesota, over fraud concerns. It also is blocking for six months any new Medicare enrollments for suppliers of durable medical equipment, prosthetics, orthotics or certain other supplies around the country to address the potential for fraud. In addition, federal officials made several arrests earlier this month related to alleged hospice fraud schemes in the Los Angeles area.
Last month, Trump signed an executive order to create an anti-fraud task force across federal benefit programs led by Vice President JD Vance. It's unclear whether Tuesday's move is part of that effort, though Oz has been working closely with Vance on other investigations related to the task force. Asked for details on the new audit, a spokesperson for CMS said the agency was researching the AP's inquiry.
Oz justified Tuesday's move by saying federal health programs in some states have enrolled large numbers of providers who aren't providing real care to patients, but instead profiting from fraud. He said the requests for states to verify the legitimacy of Medicaid providers will be focused on “high risk areas,” but didn’t explain what those entail.
Asked during the Politico interview whether there was a risk that Trump administration initiatives could eliminate, slow down or harm essential health care programs, Oz said he expects the opposite. He said Medicaid and Medicare are the “crown jewels” of our nation.
“I believe this audit and others like it will save the programs we care most about,” he said.
