Tag

Medicaid

All articles tagged with #medicaid

crime5 days ago•3 min saved

Fed probe uncovers $30M health services fraud tied to luxury-car seizures

Federal authorities say they busted a $30 million fraud conspiracy that billed for children’s behavioral health services that were never provided; 14 luxury cars, including a Maserati, Mercedes, Bentley and McLaren, were seized as prosecutors allege the ringleaders diagnosed every recipient with a behavioral adjustment disorder to bill Medicaid, while no assessments or care were ever delivered. Four defendants turned themselves in as the DOJ’s anti-fraud task force pursued charges, highlighting a scheme that exploited vulnerable youths attending camps and programs.

via CBS News|

#crime #doj #fraud

health8 days ago•2 min saved

CMS Maps Exemptions in Medicaid Work Rules

CMS guidance exempts pregnant women, parents of young children, veterans with disabilities, and other medically frail individuals from the new Medicaid work rules; most adults must meet an 80-hour-per-month work/education/volunteering requirement to keep coverage, with self-attestation allowed in year one and formal verification beginning in 2028. Homeless individuals are not exempt. States decide medical exemptions, raising fraud and administration concerns, as some projections warn millions could lose coverage by 2034 due to paperwork and system hurdles, while officials say the rule aims to boost employment.

via NBC News|

#cms #exemptions #health

health-care9 days ago•13 min saved

Cash-strapped states brace for costly Medicaid work requirements

States expanding Medicaid say implementing the federal work requirements by the 2027 deadline will require tens of millions for new staff, overtime, and IT system upgrades, with limited federal help to cover costs. Nebraska has already begun enforcing the rules, while others weigh substantial ongoing expenses and potential cuts to other services as Republicans argue the policy could yield long-term savings despite limited near-term relief.

via Politico|

#federal-funding #health-care #it-upgrades

health11 days ago•2 min saved

MassHealth sues UnitedHealthcare for $100M over senior care misclassifications

MassHealth Attorney General Andrea Campbell filed a Suffolk Superior Court lawsuit accusing UnitedHealthcare of knowingly misclassifying health assessments for seniors in the Senior Care Options plan to inflate payments, alleging at least $100 million in improper charges; UnitedHealthcare denies the claims, saying the suit misrepresents the program, while MassHealth seeks to protect taxpayer funds amid budget pressures and potential federal funding cuts.

via WBUR|

#fraud #health #masshealth

politics14 days ago•3 min saved

White House Launches Nationwide Crackdown on Government Fraud

The White House announces a sweeping, accelerated campaign led by President Trump and Vice President Vance to root out fraud in federal programs, detailing a rapid series of actions from February to May 2026—halting Medicaid payments, charging fraud rings, suspending hospice and home-health providers, launching a whistleblower program, expanding the DOJ’s fraud divisions, and triggering billions in identified or recovered losses across Medicaid, SNAP, student loans and healthcare—with audits and strike forces aimed at restoring taxpayer trust and recovering funds.

via The White House (.gov)|

#enforcement #fraud #government

crime19 days ago•181 min saved

Federal indictment charges 15 Minnesotans in multimillion-dollar social-services fraud

Federal prosecutors charged 15 Minnesotans with defrauding government social-service programs in a Covid-era scheme that authorities say siphoned more than $90 million (part of more than $250 million statewide) with about $50 million recovered; the charges span the Federal Child Nutrition Program, state childcare grants, Medicaid, and housing programs, including inflated meal counts, exaggerated staff hours, and even autism-diagnosis schemes to obtain funds. Feeding Our Future founder Aimee Bock was sentenced to nearly 42 years in prison in the broader case; the investigation included 22 search warrants and officials called it one of the nation’s largest Covid-era frauds.

via CNN|

#crime #federal-charges #fraud

local20 days ago•4 min saved

Minneapolis to host major fraud crackdown as federal indictments surface

In Minneapolis, top Trump administration officials will announce major fraud enforcement actions in Minnesota, following several federal indictments tied to healthcare, housing, and child-care schemes.

via kare11.com|

#fraud #healthcare-fraud #indictments

politics25 days ago•2 min saved

Texas Children’s Hospital to Open Detransition Clinic as Part of $10 Million Medicaid Settlement and Doctor Removals

Attorney General Paxton announced a settlement with Texas Children’s Hospital after a probe into Medicaid billing and gender-transition procedures. The hospital must establish the nation’s first detransition clinic, pay $10 million to Texas Medicaid for unallowable interventions, and permanently terminate five physicians’ privileges. The clinic will be funded by the hospital for five years and the hospital will stop providing gender-transition services, with enhanced compliance measures and bylaws to auto-revoke privileges for violations.

via Attorney General (.gov)|

#detransition #gender-transition #medicaid

health-policy25 days ago•6 min saved

Texas Children’s Hospital Ordered to Open Detransition Clinic Under $10M Settlement

Texas Attorney General Ken Paxton secured a settlement with Texas Children’s Hospital requiring the hospital to create the nation’s first detransition clinic and to pay $10 million to the state for Medicaid-billing accusations, with five physicians’ medical privileges revoked; the clinic will be funded by the hospital for five years and offered free of charge to patients, drawing mixed reactions from advocates and lawmakers within the broader debate on transgender healthcare.

via The Texas Tribune|

#detransition-clinic #gender-affirming-care #health-policy

us-news25 days ago•15 min saved

Medicaid Cuts Endanger At-Home Care for Disabled Family Members

Trump-era Medicaid reductions threaten in‑home care for millions by slashing funding for self‑directed caregiver programs; with Maryland already cutting caregiver wages and hours and other states moving toward similar cuts, families like Melissa Gonce’s—who cares for her nonverbal son Jason—face tough choices about keeping loved ones at home and maintaining stability.

via NBC News|

#budget-cuts #caregiving #disability

politics26 days ago•22 min saved

Vance's Maine anti-fraud pitch fuels debate over Trump-era corruption

Heather Cox Richardson argues that the Trump administration’s anti-fraud push, highlighted by J.D. Vance in Maine, is a partisan tactic to smear Democrats, while genuine program fraud is relatively rare and often perpetrated by criminal networks; she notes CMS cautions that “improper payments” aren’t the same as fraud and points to broader patterns of corruption and self-enrichment around Trump and allies—pardons for donors, aggressive fundraising, and overseas ventures—that complicate the narrative about fights against fraud.

via Letters from an American | Heather Cox Richardson | Substack|

#fraud #medicaid #politics

health26 days ago•21 min saved

Federal Medicaid Deferral Hits California’s Home-Health Program in Largest-Ever Move

The Trump administration is suspending about $1.1 billion in California’s Medicaid home-health program (IHSS) over fraud concerns—a claim California says has little supporting evidence and attributes to growth in caseloads and wages. The action could disrupt services for hundreds of thousands of seniors and people with disabilities, and an additional $200 million in administrative claims is also being withheld. California emphasizes safeguards and oversight, while advocates warn of harm amid a broader fraud crackdown and a related six‑month hospice enrollment moratorium, with no clear timeline for funds to be released.

via CalMatters|

#california #fraud #health

politics26 days ago•17 min saved

California Sees Medicaid Withholding as Political Retaliation

California officials condemned the White House’s withholding of roughly $1.3 billion in Medicaid reimbursements as political retaliation, while Vice President JD Vance and CMS Administrator Oz cited fraud flags in the state’s Medicaid records. Democrats warned the move harms patients and providers and signaled potential legal challenges, as Newsom highlighted in-home care programs’ savings and GOP criticisms of federal funding cuts. The action follows a recent anti-fraud crackdown in Los Angeles on hospice and home-health facilities.

via Common Dreams|

#california #fraud #jd-vance

politics27 days ago•6 min saved

Fraud crackdown prompts $1.3B Medicaid deferral for California

The Trump administration defers $1.3 billion in California Medicaid payments as part of a broader anti-fraud push, including reviews of Medicaid Fraud Control Units and a six-month moratorium on new hospice and home-health provider enrollments; officials say the measures aim to curb fraud, but critics warn about potential access issues and question their effectiveness.

via CNN|

#california #cms #fraud

politics27 days ago•2 min saved

Trump administration withholds $1.3B in California Medicaid amid fraud crackdown

The Trump administration will withhold $1.3 billion in federal Medicaid payments to California, citing the state’s inadequate anti‑fraud efforts. Vice President JD Vance announced audits of state Medicaid fraud control units and warned funds could be lost, part of a broader push against fraud in public health programs that has already included halting $259 million in Minnesota funds and a six‑month moratorium on new hospice providers as CMS investigates the industry.

via The New York Times|

#california #cms #fraud