How to prosecute the Medicaid fraudsters

This more aggressive approach is long overdue and deserves bipartisan support. It should also be applied across the board to other taxpayer-funded programs.

"American taxpayers fund a vast benefits system for citizens in need that includes housing, food, medical care, cash assistance and more," Trump's order notes. "States administer these federally funded programs, and some states have embraced loopholes that avoid individual eligibility validation, allow self-certification of eligibility, and expand eligibility far beyond what the Congress intended. Worse ... some states have refused to institute basic fraud controls such as providing enrollee information to the federal government that would allow it to verify eligibility."

As it pertains to Medicaid, the issue is urgent. Sally Pipes, a health policy expert with the Pacific Research Institute, wrote this month that the government's own audits concluded that Medicaid issued more than $540 billion in improper payments between 2015 and 2024.

Democrats have attacked these anti-fraud policies as an effort to undermine safety net programs for the impoverished. But "taxpayer resources are not limitless," Pipes observed. "It makes sense to preserve the program for those for whom it was established 60 years ago." Indeed, the more money squandered by fraud, the less available to help those who truly need it.

Others have criticized the White House for taking a vindictive approach and targeting Democratic states that may have larger Medicaid populations and more lenient eligibility requirements. It makes sense to go where the money is, but it's true that red states shouldn't be immune to scrutiny.

"We're asking the states to own that problem … red and blue, all of them," Dr. Mehmet Oz, administrator of the federal Centers for Medicare & Medicaid Services, said this week during a health care conference hosted by Politico. "If you don't take it seriously, it indicates to us that we might have to take the audits … more aggressively."

Stateline reported that, during the event, Oz "said that his agency had already halted payments to about 450 hospices and home health care centers in Los Angeles." In addition, the agency "will require every state within 30 days to turn in a plan to revalidate the health care providers that participate in their Medicaid programs."

Government estimates place the improper payment rate at nearly 7 percent — with some states higher than 20%. That's unacceptable — regardless of whether the state leans Democrat or Republican. The Trump administration is correct to attack this problem.

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