CMS Administrator Dr. Mehmet Oz is driving a hard-line campaign against Medicaid fraud, zeroing in on high-risk providers, hospices, and durable medical equipment suppliers. The push targets a handful of states with obvious hot spots while putting all 50 states on notice to clean up their systems or face federal action. This article lays out what officials are uncovering, why foreign actors and organized crime are worrying signs, and how the administration is forcing accountability for taxpayers. Expect continued pressure from the federal level and sharper oversight where abuse has been worst.
Dr. Oz has publicly named several states as immediate priorities while making clear the concern stretches nationwide. “We’ve written letters to Minnesota, California, a letter to Florida because we’re worried about the durable medical equipment fraud, New York, Maine, and there are more coming,” he said, signaling that enforcement will not be limited to partisan boundaries. The administration is pushing states to own the problem and act fast to protect Medicaid integrity.
The move comes after huge schemes surfaced, like Minnesota’s massive “Feeding Our Future” scandal, where millions meant for vulnerable people were diverted. CMS officials say Medicaid and hospice programs have been exploited, with fraud sometimes involving complex networks that mask foreign influence. That pattern has prompted federal audits and moratoriums where abuse appears concentrated.
“We know the Cuban government seems to be implicated in some issues in South Florida, where you have twice as many durable medical equipment suppliers selling wheelchairs and knee braces than McDonald’s,” said Oz, calling out geographic clusters that both state and federal authorities should not ignore. The image of streets saturated with shell suppliers captures how blatant some of this gaming has become, and it makes the case for immediate moratoria and tough revalidation steps.
The Vice President’s anti-fraud effort has also stepped into the ring, putting DME, prosthetics, orthotics, and supplies under a nationwide moratorium in hot zones. “The task force is committed to ensuring that American tax dollars are used for the benefit of the American people, and will continue to successfully do exactly that,” a spokesperson said. That cooperation between CMS and the task force gives the effort teeth and a single-minded focus on stopping wasteful payouts.
Federal investigators are flagging troubling signs of organized crime and foreign actors intertwined with these schemes. “We have evidence that foreign nationals certainly are involved in a lot of this fraud. There’s a Russian mafia presence in Los Angeles. There’s Chinese mafia presence, for example, in Flushing Queens [New York,],” Oz said, naming criminal networks that complicate enforcement and recovery of stolen funds. When fraud includes transnational elements, it becomes harder for local agencies to track and for taxpayers to recoup losses.
Hospice care has been another glaring weak spot, with hundreds of providers suspended after officials noticed unlikely survival statistics. Investigators saw programs meant for people in their last six months recording suspiciously high survival rates, which triggered deeper reviews. “We also began to notice that there were some folks who were probably not honorable doctors who were designated to supervise patients in multiple hospices,” said Oz.
A further red flag was ownership structures that shielded wrongdoing and skirted reporting rules. “A lot of hospitals had foreigners that owned them, or they were able to cheat by keeping the numbers of their membership low enough that they don’t have to actually report their outcomes,” Oz explained, pointing to manipulation of patient counts and oversight gaps. Officials used those findings to suspend more than 400 hospices from receiving payments while probes continue.
To force action, CMS ordered governors and state Medicaid leaders to revalidate high-risk providers on a fast timeline, demanding quick commitments and a broader plan. “We can audit states that don’t want to comply with the revalidation request,” said Oz, making clear the federal government will not sit back if states stall. He also urged a practical approach: “Let’s revalidate, which means double check that everyone is providing services within Medicaid, especially for these high-risk services where these are the things your family would normally do for you,” he said.
Investigators are also scrutinizing fringe services that often hide fraud, from dubious behavioral aides to non-emergency transport and grocery delivery labeled as medical support. Oz asked pointedly about credentials and oversight: “Like what do these people actually have as credentials to allow them to be able to this? And so we asked this question of all the states and all 50 now are charged within 10 days of telling us whether they want to work with us,” he said. That demand forces state leaders to either cooperate or face federal intervention.
Officials estimate the theft and overbilling run into the billions each year, bleeding resources meant for legitimate care and starving patients of services. “This is an important issue for Americans to recognize because the states run Medicaid, but the federal taxpayer foots the bill,” said Oz, putting the financial and moral stakes plainly. The message from Washington is simple: clean up fraud now, or taxpayers will keep paying the price.
