The action was part of a nationwide crackdown on fraud, waste, and abuse in the Medicare and Medicaid systems.
The Trump administration will withhold $1.3 billion in Medicaid payments to California due to potentially fraudulent billing patterns, Vice President JD Vance announced on May 13.
The action comes among a host of others taken recently to crack down on fraudulent activity in Medicare and Medicaid.
“We want to protect these programs for the kids and the families who need them. We want to ensure that the American taxpayer isn’t getting fleeced,” Vance told reporters.
Analysis of Medicaid billing patterns in California aroused suspicion, according to Dr. Mehmet Oz, administrator of the Centers for Medicare and Medicaid Services.
“We’ve discovered $630 million in billing from folks who are egregiously the top 5 percent of outliers in billing. These numbers are so big you can’t imagine anyone billing for these [amounts],” Oz told reporters.
California itself is an outlier among states, Oz said.
“In California, the growth of spending on personal care services is twice the rate of the average of the rest of the country,” Oz said.
“We estimate there’s $500 million that could be a risk of being taken from federal taxpayers.”
Fewer than 20 of 800 Medicare providers recently removed from the program due to suspicious billing activity have called to complain, Oz said, offering that as evidence that they likely were not legitimate providers.
This is a developing news story and will be updated.
