Preventing Fraud Before It Happens

On Wednesday, American Greatness posted an article about the federal government’s efforts to end Medicaid fraud in blue states.

The article reports:

The Trump administration moved Tuesday to withhold more than $1 billion in federal Medicaid dollars from California and Minnesota, the latest step in the campaign to root out fraud and waste in blue-state health programs.

The Centers for Medicare and Medicaid Services (CMS) said it is deferring roughly $867.5 million in payments to California and $199 million to Minnesota after financial reviews turned up claims the agency could not verify, particularly in in-home care programs.

The decision extends a pattern of federal scrutiny aimed squarely at Democrat-led states that critics say have long been lax about policing how taxpayer money moves through their Medicaid systems. Minnesota in particular has already drawn federal attention this year, after the administration pointed to the state’s failure to control fraud as one justification for last year’s ICE enforcement surge there.

CMS said its review of California’s claims was triggered after officials noticed spending growth in certain in-home care programs that outpaced national trends, along with a broader set of claims the agency said simply lacked adequate documentation. In Minnesota, CMS flagged claims across 14 service areas, including payments tied to providers previously identified through the state’s own program integrity reviews, a detail that raises questions about why those payments continued at all.

The article notes that officials have also imposed a six-month moratorium on enrolling new hospice and home health providers into Medicare nationwide, citing those sectors as persistent hotspots for fraudulent billing. These are our tax dollars that are paying for lavish lifestyles for dishonest people. We need to improve our screening process before we give out any more money.