{"id":407422,"date":"2026-07-22T02:32:14","date_gmt":"2026-07-22T02:32:14","guid":{"rendered":"https:\/\/www.newsbeep.com\/us-ca\/407422\/"},"modified":"2026-07-22T02:32:14","modified_gmt":"2026-07-22T02:32:14","slug":"trump-administration-halts-867m-in-medicaid-payments-to-california-over-suspected-fraud","status":"publish","type":"post","link":"https:\/\/www.newsbeep.com\/us-ca\/407422\/","title":{"rendered":"Trump administration halts $867M in Medicaid payments to California over suspected fraud"},"content":{"rendered":"

The Trump administration announced Tuesday that it\u2019s halting more than $867 million in federal Medicaid payments to the Golden State over suspected fraud<\/a> \u2014 with one expert describing it as a \u201cpiece of cake\u201d for scammers to cash in.<\/p>\n

\u201cWe are not sending Medicaid dollars out the door until we have confidence that they are being spent lawfully and appropriately,\u201d Health and Human Services Secretary Robert F. Kennedy Jr. said during a press conference Tuesday.<\/p>\n

Health and Human Services Secretary Robert F. Kennedy Jr. said the Trump administration is halting over $1 billion in medicaid payments to California and Minnesota. ZUMAPRESS.com<\/p>\n

The scandal centers around California\u2019s In-Home Supportive Services (IHSS), a Medicaid-funded program that pays caregivers \u2014 often a family member \u2014 to help elderly and disabled residents at home instead of moving into a facility.\u00a0<\/p>\n

Over the past two years, Centers for Medicare & Medicaid Services (CMS) Administrator Mehmet Oz said California\u2019s spending for in-home services was \u201ctwice the rate of the average of the rest of the entire nation.\u201d \u00a0<\/p>\n

CMS administrator Mehmet Oz said California\u2019s spending for in-home services was \u201ctwice the rate of the average of the rest of the entire nation.\u201d \u00a0 REUTERS<\/p>\n

\u201cIf it smells like fraud, we\u2019re not paying for it anymore,\u201d he said, adding that CMS is deferring payments until California can \u201csubstantiate their claims from this past quarter audit.\u201d\u00a0<\/p>\n

Roughly $199 million in Medicaid funding in Minnesota was also frozen as part of the action.<\/p>\n

Oz said CMS flagged suspicious billing patterns, including providers who submitted claims more than a year after services were provided, billed four or more patients simultaneously or ranked among the top 2.5% of billers nationwide.<\/p>\n

Haywood Talcove, CEO of LexisNexis Risk Solutions for Government and a nationally recognized fraud expert, told The California Post that taxpayers should be \u201coutraged\u201d over the alleged lack of oversight that he said enables widespread fraud in California.\u00a0<\/p>\n

\u201cAnytime you have a program like this where it is self-reported, there is virtually no auditing, and no one gets caught, then the probability of fraud is very, very high,\u201d he said, estimating that fraud accounts for roughly 20% of the IHSS program.<\/p>\n

Oz said CMS flagged suspicious billing patterns, including providers who submitted claims more than a year after services were provided. via REUTERS<\/p>\n

Talcove explained how fraudsters can exploit IHSS, describing the process as a \u201cpiece of cake.\u201d \u00a0<\/p>\n

According to Talcove, the fraud scheme begins when someone submits an IHSS application claiming to need in-home care, then designates a caregiver and persuades a licensed healthcare professional to falsely certify their need for care in exchange for a \u201ccut.\u201d<\/p>\n

\u201cI\u2019ll tell you that your fake person that doesn\u2019t exist needs home healthcare, and guess what? You\u2019re going to give me a little cut. That\u2019s how it goes,\u201d Talcove said, adding that the \u201cstate doesn\u2019t have the technology, doesn\u2019t have the people, and doesn\u2019t have the systems to validate it.\u201d\u00a0<\/p>\n

There are more than 500,000 people enrolled in California\u2019s In-Home Supportive Services (IHSS). Getty Images<\/p>\n

Talcove argued California lacks the staffing, technology and incentive to adequately verify the state\u2019s more than 500,000 IHSS recipients.<\/p>\n

\u201cThere\u2019s no money that comes out of the state pocket,\u201d he said. \u201cThe incentive structure \u2014 federally funded, state-administered \u2014 is a recipe for disaster.\u201d\u00a0<\/p>\n

California Governor Gavin Newsom rejected the administration\u2019s claims of rampant fraud, describing the decision to halt payments as \u201cpure politics<\/a>.\u201d\u00a0<\/p>\n

California Governor Gavin Newsom called Tuesday\u2019s announcement \u201cpure politics.\u201d Carlin Stiehl for CA Post<\/p>\n

\u201cWe take fraud seriously,\u201d Newsom said. \u201cWe don\u2019t politicize it like these guys.\u201d\u00a0<\/p>\n

The governor claimed that Tuesday\u2019s announcement was an attack on his potential successor\u00a0Xavier Becerra<\/a>, the Democratic candidate for governor and a former Health and Human Services chief under former President Biden.<\/p>\n

Newsom also said his office has been actively cooperating with the Trump administration, pointing to communications in which information requested from California was already provided.\u00a0<\/p>\n

\u201cCalifornia\u2019s approach, which had been long approved by CMS, saves federal and state taxpayers money,\u201d a spokesperson for Newsom\u2019s office told The Post. \u201cOne year of in-home care saves state and federal taxpayers approximately $100,000 per person annually versus nursing facility care.\u00a0A 2020 California State Auditor report found no program integrity concerns and recommended increasing reimbursement rates to grow the in-home care provider workforce and reduce reliance on costly institutional care.\u201d\u00a0<\/p>\n

Kennedy said California and Minnesota will have to provide documentation proving the payments are legitimate if they want to restore funding. REUTERS<\/p>\n

Talcove believes the only way to prevent future fraud and abuse is to issue block grants and give the money directly to the states, or have the program fully funded and administered at the federal level.\u00a0<\/p>\n

\u201cYou can\u2019t arrest and prosecute your way out of this,\u201d he said.\u00a0<\/p>\n

In May, the Trump administration withheld $1.3 billion in Medicaid funding<\/a> from California over mounting concerns tied to the state\u2019s hospice and home-health agencies \u2014 bringing the current total over $2 billion.\u00a0<\/p>\n

The funds will be frozen until California and Minnesota can substantiate their claims and while federal officers review \u201chigh-risk\u201d Medicaid claims.\u00a0<\/p>\n

\u201cThey need to provide documentation that these payments are legitimate,\u201d Kennedy said.\u00a0<\/p>\n","protected":false},"excerpt":{"rendered":"The Trump administration announced Tuesday that it\u2019s halting more than $867 million in federal Medicaid payments to the…\n","protected":false},"author":2,"featured_media":407423,"comment_status":"","ping_status":"","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[6],"tags":[7,9,8,3130,457,16709,15768,13,37136,1519,3586],"class_list":["post-407422","post","type-post","status-publish","format-standard","has-post-thumbnail","category-california","tag-california","tag-california-headlines","tag-california-news","tag-fraud","tag-gavin-newsom","tag-medicaid","tag-medicare","tag-politics","tag-robert-f-kennedy-jr","tag-trump","tag-us-news"],"_links":{"self":[{"href":"https:\/\/www.newsbeep.com\/us-ca\/wp-json\/wp\/v2\/posts\/407422","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=407422"}],"version-history":[{"count":0,"href":"https:\/\/www.newsbeep.com\/us-ca\/wp-json\/wp\/v2\/posts\/407422\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/www.newsbeep.com\/us-ca\/wp-json\/wp\/v2\/media\/407423"}],"wp:attachment":[{"href":"https:\/\/www.newsbeep.com\/us-ca\/wp-json\/wp\/v2\/media?parent=407422"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.newsbeep.com\/us-ca\/wp-json\/wp\/v2\/categories?post=407422"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.newsbeep.com\/us-ca\/wp-json\/wp\/v2\/tags?post=407422"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}