WASHINGTON (TNND) — Medicaid fraud is costing taxpayers billions of dollars, and federal officials say recent cases in New York and Minnesota show why tougher enforcement is needed.
Centers for Medicare and Medicaid Services Administrator Dr. Mehmet Oz told The National News Desk he visited Queens last week and saw examples of what he described as blatant abuse of the system. (TNND)
In New York City, federal agents raided adult day care centers as part of an investigation into alleged kickbacks, money laundering and billing for services that were never provided. Centers for Medicare and Medicaid Services Administrator Dr. Mehmet Oz told The National News Desk he visited Queens last week and saw examples of what he described as blatant abuse of the system.
“When I went to Queens last week, and you see some of these images of the different investigations that we launched, we had a hundred different adult daycare centers approached by different members of law enforcement,” Oz said.
Oz described one location where, he said, the facility was billing Medicaid for patients using wheelchairs even though the building was not accessible.
“I walked in one of these places and I said, do you have people with wheelchairs coming to here? The guy said no. Well, it turns out they’re building us for a lot of patients with wheelchairs and you can’t even get in the place because of the stairs with a wheelchair,” Oz said. He added that an ambulance service owned by the same company “was bilking us for lots of money.”
Oz also criticized what he described as schemes in which seniors are lured in with bribes and their Medicare numbers are then used to bill for services that are not actually delivered.
“Why are you allowing bribes to attract customers that then can be used with those Medicare numbers that they get from these customers to build the American people for tens of thousands of dollars of services for every person that aren’t being used,” he said. “It’s infuriating. We have to put an end to it.”
In Minnesota, an appeals court reinstated a $7.2 million Medicaid fraud conviction after a Democratic-appointed judge had tossed it out. The case involved billing for services that did not exist, and the money was apparently spent on luxury goods. Oz pointed to the Minnesota case as an example of why he believes enforcement must be consistent.
Minnesota, you just covered, nothing good example. Law enforcement did the right thing. They prosecuted a case; a man had stolen seven-plus million dollars from Medicaid. And yet another judge comes in and overturns the jury,” Oz said.
He said the appeals court threw out the judge’s rejection of the verdict.
Oz said CMS is increasing scrutiny before money is paid out, describing a strategy of double-checking and triple-checking claims.
“We are telling everybody that the money is not leaving the building,” he said, adding that the approach is “saving taxpayers tens of billions of dollars.”
Oz also said CMS is coordinating with other federal agencies when it identifies suspected fraud.
“I can send that information to both the Department of Justice; I can also send it to the IRS,” he said. “Because here’s the story, if you steal from poor people, you’re probably not paying your taxes.”
The discussion also turned to rural health care funding. Oz said states are receiving the first round of the $50 billion Rural Health Transformation Funds, averaging about $200 million each, and he predicted voters would see results quickly.
“Voters are gonna see the benefits immediately. The money was sent out from Washington,” he said.
Oz said the funding is aimed at broader changes beyond keeping hospitals open, including telemedicine, improved medical records, and training more doctors and nurses. He said the money “had to go out by the end of this week,” and he argued it will help “improve their life expectancy” and “re-invigorate these parts of our nation.”