A month’s worth of fraud busting in 10 notable quotes

A lot has happened in the national war on healthcare fraud over the five months since citizen journalist Nick Shirley’s videos went viral on X just ahead of New Year’s Day.  

Shirley’s initial head-turning post focused the nation’s attention on Minnesota, but neither the negative publicity for the North Star State nor the White House’s response stayed put.

• In March, President Trump launched a federal anti-fraud task force and assigned Vice President JD Vance to head it. 
   
• In April, the Centers for Medicare and Medicaid Services (CMS) instructed all state governors and Medicaid directors to quickly “revalidate” Medicaid providers that lack a National Provider Identifier (NPI) and/or have not been recently screened for vulnerabilities.
   
• This month, HHS’s Senior Medicare Patrol program designated the first workweek of June Medicare Fraud Prevention Week. (The SMP program is run locally in all 50 states plus D.C. and three territories, but it’s federally funded and overseen by HHS’s Administration for Community Living.)

Ahead of June 1 to 5, here’s a timeline of fraud-related news, views and developments as captured in concise statements uttered or written in May. 

 

1. ‘We have created a war room at CMS to catch the fraud in real time before the money leaves the federal coffers.’ 

—CMS Administrator Mehmet Oz, MD, MBA (May 4)

2. ‘We have red states and blue states that go after fraud aggressively, but we also unfortunately have some states, mostly blue states unfortunately, that do not take Medicaid fraud very seriously.’

—Vice President JD Vance (May 13) 

3. ‘We must stop crushing honest providers and their patients with rules that make them less free than their peers in other nations to provide and receive care.’

— Center for Modern Health analysts Reinier Schuur, PhD, and Colleen Smith, MD (May 13)

4. ‘New uncertainty about the availability of federal funding could have implications for Medicaid enrollees and providers who are not involved in fraud.’

— KFF analysts Jessica Mathers, MPP, Alice Burns, PhD, and Robin Rudowitz, MPA (May 15)

5. ‘The HHS Office of Inspector General is auditing every Medicaid Fraud Control Unit as part of its sweeping efforts to crack down on healthcare fraud. … HHS has threatened to freeze all federal Medicaid funds to states it deems noncompliant.’ 

—Modern Healthcare regulatory reporter Bridget Early (May 19)

6. ‘It’s classic big government: Everyone files an audit and it lands with a thud and no one does anything about it. With AI, we’re able to dig into it.’ 

—HHS Assistant Secretary for Financial Resources Gustav Chiarello, JD (May 21) 

7. ‘Federal prosecutors have estimated the fraud scandal in Minnesota could top $9 billion, a figure that has been disputed by Gov. Tim Walz.’

—CBS Minnesota reporter Aki Nace (May 22)

8. ‘The White House Task Force to Eliminate Fraud is moving at unprecedented speed and ferocity to root out the waste, abuse and criminal exploitation of government programs that have drained billions from hardworking taxpayers.’

—The White House (May 26)

9. ‘The Trump administration should require a trust-but-verify policy for meeting the Medicaid work requirement. ... This commonsense safeguard would prevent individuals from gaming the system.’

—Paragon Health Institute representatives Chris Medrano and Brian Blase, PhD (May 26)

10. ‘Healthcare fraud exists because of the vast amounts of government money available, the complex systems that make cheating easy to hide and progressive politicians happy to shovel money out the door.’ 

—Institute for Policy Innovation resident scholar Merrill Matthews, PhD (May 26)