Federal Agents Raid NYC Adult Day Care Centers in Massive Medicaid Fraud Crackdown

Key points

• CMS Administrator Mehmet Oz visited Kent Senior Care and Evergreen Adult Day Care in Flushing, Queens, on October 20, 2026, to deliver warning letters regarding suspicious billing practices.
• The crackdown involved more than 80 visits to providers across New York City, with simultaneous raids in Brooklyn, Staten Island, and Queens by the FBI, HSI, IRS, and NYPD.
• Oz questioned staff about attendance records that included future dates, billing for wheelchair services without visible wheelchairs, and discrepancies between billed numbers and actual occupancy.
• Oz alleged that organized criminal networks, including groups he described as connected to the 'Chinese mafia,' were paying seniors $1,000 to $1,200 to attend facilities to facilitate fraudulent billing.
• New York Governor Kathy Hochul stated the investigation has been ongoing for months and aims to combat money laundering, kickbacks, and improper billing, noting the state has saved over $15 billion in Medicaid funds since 2021.

Background

This action follows a broader federal push to combat healthcare fraud, including previous cancellations of ACA plans and investigations into other state programs. The current crackdown targets adult day care centers, a sector where Medicaid reimbursement depends on documented attendance and services. Previous archive items indicate a trend of federal scrutiny regarding Medicaid and healthcare insurance fraud, with officials citing rising costs and suspicious billing patterns. The current operation is part of a months-long investigation, suggesting a sustained effort to address systemic issues in the Medicaid program.

How outlets are covering it

Fox News emphasized the direct confrontation between CMS Administrator Mehmet Oz and facility staff, highlighting specific billing discrepancies and Oz's allegations of organized crime involvement. CBS News focused on the multi-agency nature of the operation, confirming that federal agents were conducting court-authorized actions across multiple boroughs, including Brooklyn and Staten Island. amNewYork provided on-the-ground details of the raids, noting the removal of boxes and computers from a facility in Flushing and confirming the involvement of the IRS and NYPD. While Fox News highlighted Oz's specific claims about 'Chinese mafia' ties, CBS and amNewYork focused on the broader law enforcement coordination and the state's role, with Hochul emphasizing the financial impact and the need for accountability. All sources agreed on the scale of the operation and the involvement of multiple federal and state agencies, but differed in the level of detail regarding specific allegations and the nature of the evidence collected.

Why it matters

The crackdown signals a significant shift in federal and state enforcement against Medicaid fraud, targeting a sector that provides essential services to seniors. The involvement of high-profile officials like Mehmet Oz and the coordination of multiple agencies, including the FBI and HSI, indicates a serious effort to address potential systemic fraud. The allegations of organized crime involvement and the potential link to money laundering and human trafficking suggest that the fraud may be more extensive than previously thought. The operation could lead to significant financial recoveries and stricter oversight of Medicaid providers, impacting the availability and quality of services for seniors. It also highlights the ongoing tension between federal and state authorities in addressing healthcare fraud and the potential impact on vulnerable populations.

What to watch

The investigation is ongoing, with no arrests or charges announced at the time of reporting. Federal and state authorities are likely to continue gathering evidence and pursuing legal action against providers found to be engaged in fraudulent activities. The crackdown may lead to stricter regulations and oversight of adult day care centers, potentially affecting the operations of legitimate providers. The financial impact of the fraud, estimated at nearly $1 billion annually, suggests that the investigation could result in significant financial recoveries. The outcome of the investigation will likely influence future policies and enforcement actions related to Medicaid fraud, potentially leading to broader reforms in the healthcare system.