News · Health care · National (US)
A 27-minute film follows CMS Administrator Mehmet Oz as federal agencies examine suspected fraud involving Medicare, Medicaid and hospice care.
Key takeaways
Centers for Medicare & Medicaid Services Administrator Dr. Mehmet Oz appears in a new 27-minute film about suspected fraud involving Medicare, Medicaid, hospice care and other taxpayer-funded health programs. Health and Human Services Secretary Robert F. Kennedy Jr. and CMS Deputy Administrator Kim Brandt also appear.
The film follows Oz to locations around the country as he describes how officials examine billing and search for signs that providers may be charging government programs improperly. One segment focuses on the Los Angeles area, where Oz said about 2,000 hospice providers operate. CMS has suspended 800 California hospice providers over an alleged Medicare fraud scheme involving billion, Fox News reported.
Oz joined federal and local agencies in New York City on Oct. 20 as officials delivered letters and conducted searches at social adult day care centers. More than 80 providers received CMS warning letters concerning billing practices.
The operation involved CMS, the FBI, the Department of Health and Human Services Office of Inspector General, the New York Police Department and other agencies. The FBI said the activity in Queens, Staten Island, Brooklyn and other parts of the city was connected to continuing federal investigations.
Oz identified several issues for further scrutiny, including low attendance alongside high Medicaid billing, wheelchair transportation charges, clients entering without signing in, conflicting attendance records and sign-in sheets dated for future days. Those observations are allegations under investigation, not findings that a provider committed fraud.
Federal investigators can review billing records, attendance documents and transportation claims to determine whether payments were improper. Warning letters and searches do not by themselves establish wrongdoing; any penalties or criminal charges would require additional agency action.
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