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CMS officials warn of large, multinational Medicaid fraud and say agency is considering payment deferrals pending audits
Summary
Officials described program‑integrity concerns — including DME provider "bust outs," hospice overuse and alleged overseas involvement — and said CMS is "looking at deferring payments based on audits" while coordinating with Treasury, DOJ, OIG and FBI; officials estimated fraud could be as much as $100 billion.
During a question-and-answer session, reporters pressed CMS officials on program‑integrity enforcement and the scale of alleged Medicaid fraud.
A reporter asked whether CMS would suspend or withhold federal Medicaid payments from states that do not produce program‑integrity plans. Administrator Oz replied that the agency is "looking at deferring payments based on audits" for February 2025 while it gathers more data. Oz said CMS is coordinating with Treasury, the Department of Justice, the Office of Inspector…
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