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NEW YORK (AP) — In a significant move to intensify anti-fraud measures nationwide, the Trump administration is mandating that all 50 states outline their strategies to reassess certain Medicaid providers. This initiative marks a shift from the previous focus on individual states, Dr. Mehmet Oz announced on Tuesday.
During a Politico healthcare summit, the Centers for Medicare and Medicaid Services (CMS) Administrator revealed plans to urge states to take responsibility for addressing healthcare fraud. States will be required to submit their plans within 30 days. “This is a measure to demonstrate their commitment to addressing this issue,” Oz stated. “Failure to comply may lead us to intensify audits across different states,” he added, without providing further details.
The announcement forms part of a broader federal effort to combat waste, fraud, and abuse within the Medicaid and Medicare programs. Previously, the focus had primarily been on Democratic-led states, and there have been instances of mistaken accusations.
Beyond New York, CMS has initiated investigations in at least four other states concerning potential healthcare fraud. In one notable action, Medicaid payments totaling $243 million were suspended in Minnesota due to fraud concerns. Additionally, the CMS has imposed a six-month halt on new Medicare enrollments for suppliers of durable medical equipment, prosthetics, and orthotics nationwide to curb possible fraudulent activities. Earlier this month, federal authorities also conducted several arrests in connection to alleged hospice fraud schemes in the Los Angeles area.
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.
Minnesota Gov. Tim Walz, who the Trump administration and congressional Republicans have blamed for allowing fraud to happen in federally funded programs including Medicaid, welcomed Oz’s announcement.
Walz told reporters Tuesday that Minnesota hadn’t received the request yet, but the Democratic governor said his state is already moving ahead with the revalidation process and has made significant improvements. Minnesota sued CMS in February in an attempt to stop it from withholding Medicaid funds. That case is still ongoing, and the money has not yet been released, but CMS wrote to state officials last month that the agency had approved the state’s corrective action plan.
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.
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