Trump administration freezes $867M in California Medicaid funds over suspected fraud

The Trump administration announced Tuesday that it’s halting more than $867 million in federal Medicaid payments to the Golden State over suspected fraud — with one expert describing it as a “piece of cake” for scammers to cash in.“We are not sending Medicaid dollars out the door until we have confidence that they are being spent lawfully and appropriately,” Health and Human Services Secretary Robert F.Kennedy Jr.

said during a press conference Tuesday.The scandal centers around California’s In-Home Supportive Services (IHSS), a Medicaid-funded program that pays caregivers — often a family member — to help elderly and disabled residents at home instead of moving into a facility. Over the past two years, Centers for Medicare & Medicaid Services (CMS) Administrator Mehmet Oz said California’s spending for in-home services was “twice the rate of the average of the rest of the entire nation.”  “If it smells like fraud, we’re not paying for it anymore,” he said, adding that CMS is deferring payments until California can “substantiate their claims from this past quarter audit.” Roughly $199 million in Medicaid funding in Minnesota was also frozen as part of the action.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.Haywood Talcove, CEO of LexisNexis Risk Solutions for Government and a nationally recognized fraud expert, told The California Post that taxpayers should be “outraged” over the alleged lack of oversight that he said enables widespread fraud in California. “Anytime 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,” he said, estimating that fraud accounts for roughly 20% of the IHSS program.Talcove explained how fraudsters...