news conference<\/a> with Vice President JD Vance, Oz and other officials discussed anti-fraud initiatives and how different states were, or were not, cooperating with them.<\/p>\n\u201cCalifornia has not taken fraud very seriously,\u201d Oz said. He said the state\u2019s \u201csubmissions of Medicare records and the backup estimates are generating major red flags,\u201d including $630 million in suspicious billings \u201cfrom the folks who are egregiously the top 5% of outliers in billing.\u201d These were \u201cnumbers so big, you can\u2019t imagine anyone billing for these numbers of patients and that much for each patient,\u201d he said, \u201cand so, we\u2019re asking California to clarify for us how it got there.\u201d<\/p>\n
Something else the anti-fraud task force found: California\u2019s spending growth for in-home services is \u201ctwice the rate of the average of the rest of the country.\u201d<\/p>\n
The task force also stopped $200 million in \u201cquestionable expenditures,\u201d much of it \u201clinked to immigration-related costs, folks who are undocumented.\u201d\u00a0<\/p>\n
\u201cWe\u2019d like the state to at least come to the table and explain to us how these outlier payments have been generated,\u201d Oz said. But it won\u2019t. So the federal government froze $1.34 billion that California would have received for its Medicaid Fraud Control Unit, an action Oz said was taken \u201cbecause we want California to get serious about this fraud.\u201d<\/p>\n
Instead of getting serious, California is trying to raise taxes to keep the scam going. Assemblyman Isaac Bryan cited the $1.34 billion funding freeze on the Assembly floor as a reason to pass Assembly Bill 1768, which will allow tax increases in Los Angeles and Contra Costa Counties to exceed the state cap on local sales taxes. Bryan made it sound as if patients would be hurt by the freeze, but in fact, the frozen funds are exclusively for fraud investigations that the state won\u2019t do.<\/p>\n
Why not?<\/p>\n
The anti-fraud task force has a theory. \u201cWe are concerned that some governors see these programs as jobs programs,\u201d Oz said, in a way that \u201cresembles political patronage.\u201d<\/p>\n
That could explain the lack of follow-up after the California state auditor warned in 2022 of exactly the hospice fraud found in 2026. Oz said the California Department of Health finally adopted a rule in December to mandate, starting January 1, that an individual provider cannot have more than one hospice. \u201cThis is a red flag issue,\u201d he said. \u201cWhy would a doctor need to have 20 hospices?\u201d\u00a0<\/p>\n
Guess what happened to that rule. \u201cFor reasons we don\u2019t understand, and I\u2019d love to pose that right here to the state of California, someone very senior in their government pulled down that rule, never let it issue, and we never got help from them,\u201d Oz said. \u201cThat\u2019s why we went out the first week of January to say, \u2018What\u2019s going on here?\u2019\u201d<\/p>\n
It\u2019s a rhetorical question. He knows. We all do.<\/p>\n
Write Susan@SusanShelley.com and follow her on X @Susan_Shelley<\/p>\n","protected":false},"excerpt":{"rendered":"One way to judge an elected official is to evaluate his or her reaction when confronted with strong…\n","protected":false},"author":2,"featured_media":329416,"comment_status":"","ping_status":"","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[6],"tags":[7,9,8,975,2082],"class_list":["post-329415","post","type-post","status-publish","format-standard","has-post-thumbnail","category-california","tag-california","tag-california-headlines","tag-california-news","tag-opinion","tag-opinion-columnists"],"_links":{"self":[{"href":"https:\/\/www.newsbeep.com\/us-ca\/wp-json\/wp\/v2\/posts\/329415","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.newsbeep.com\/us-ca\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.newsbeep.com\/us-ca\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.newsbeep.com\/us-ca\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/www.newsbeep.com\/us-ca\/wp-json\/wp\/v2\/comments?post=329415"}],"version-history":[{"count":0,"href":"https:\/\/www.newsbeep.com\/us-ca\/wp-json\/wp\/v2\/posts\/329415\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/www.newsbeep.com\/us-ca\/wp-json\/wp\/v2\/media\/329416"}],"wp:attachment":[{"href":"https:\/\/www.newsbeep.com\/us-ca\/wp-json\/wp\/v2\/media?parent=329415"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.newsbeep.com\/us-ca\/wp-json\/wp\/v2\/categories?post=329415"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.newsbeep.com\/us-ca\/wp-json\/wp\/v2\/tags?post=329415"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}