Mother Jones
Dr. Oz Calls Medicare Fraud an Epidemic. Trump Keeps Pardoning the Culprits.
On Tuesday, the oversight and investigations arm of the House Committee on Energy and Commerce held a hearing to discuss alleged Medicare and Medicaid fraud—a major talking point of the Trump administration and Robert F. Kennedy’s Department of Health and Human Services, which have deployed fraud claims to help justify cuts to critical funding and programs used by a huge swath of aging, disabled, and low-income Americans.
“For too long, states have been permitted to run Medicaid programs with weak guardrails, making them easy targets for criminals to exploit,” subcommittee chair John Joyce (R-Pa.) said in his opening statement. “Under the leadership of Dr. Mehmet Oz, this administration is taking bold steps to stop this fraud more than any other presidential administration before it.”
There are false and exaggerated claims in systems the size of Medicare and Medicaid—both Republican and Democratic members agreed that fraud from providers does exist. But only Democratic members raised concerns that withholding Medicaid funds from Minnesota, for example—where investigations into large-scale social services fraud have become a major conservative talking point—will hurt disabled and aging people, as well as children. Centers for Medicare and Medicaid Services administrator Dr. Mehmet Oz, who has made similar allegations about “ethnic” fraud in the Los Angeles area, was not present, something Rep. Frank Pallone (D-N.J.) took offense to.
“I think he’s just a grandstander who likes to go on TV but doesn’t really do anything substantively that’s meaningful to help Medicare and Medicaid recipients,” Pallone said.
In Oz’s absence, CMS deputy administrator Kimberly Brandt claimed that the agency’s “fraud war room” was using artificial intelligence to root out alleged Medicare and Medicaid fraud, particularly increased rates of home and community-based services billing in New York and California.
“We are constantly using heat maps and data analysis to be able to look and see where we think the largest shifts are,” Brandt said.
A recent article published in the Health Affairs journal by four academics focusing on health and disability warned that such a focus by the Trump administration could lead to HCBS, an optional Medicaid program, being further dismantled. “Growth in HCBS spending does not reflect evidence of systemic corruption but rather bipartisan federal policy choices, demographic change, and structured statutory evolution,” they wrote. It is also not an easy process to qualify for HCBS, with each process slightly different per state, and over half a million people on waiting lists to even qualify.
Rep. Kevin Mullen (D-Calif.) said that he was very concerned that his constituents could lose access to Medicaid services if California came under the kinds of attacks that Minnesota now faces from federal agencies.
“My constituents deserve better than to have their lifesaving health care used as a pawn,” Mullen said.
During her turn on the floor, Rep. Lori Trahan (D-Mass.) raised doubts that the Trump administration actually cares about rooting out Medicaid and Medicare fraud.
“Donald Trump unilaterally fired the HHS inspector general immediately after taking office, contradicting his claim that combating fraud is a central goal of this administration,” Trahan said. “Not only did the President move the leading official for detecting fraud in Medicare and Medicaid, but he left the role unfilled for almost an entire year to then fill it with a partisan loyalist.”
Trahan also listed the names of convicted fraudsters of Medicaid and Medicare fraud who were pardoned by Trump, including Philip Esformes.
“These cases involve large-scale fraud against taxpayer funded health care programs intended to serve seniors, people with disabilities and low income families—and the President of the United States freed every single perpetrator of those crimes,” Trahan said.