Dr. Mehmet Oz, the Trump administration official overseeing the federal Medicaid program, is accusing New York of allowing rampant fraud within its sprawling $110 billion Medicaid system, alleging that Chinese organized crime groups are exploiting the program through billions of dollars in fraudulent medical claims.
Speaking Sunday on 77 WABC’s “Cats Roundtable,” the administrator of the Centers for Medicare & Medicaid Services argued that abuse of taxpayer-funded safety net programs has become widespread and, in some cases, is being orchestrated by overseas criminal organizations.
“Social safety net programs are being defrauded. They’re being hurt oftentimes by foreign governments or foreign-run criminal syndicate organizations,” Oz, administrator of the US Centers for Medicare & Medicaid Services, said Sunday on 77 WABC ‘s the “Cats Roundtable” program.
Oz recently visited Flushing, Queens, where he toured an area containing 64 adult social care centers that primarily serve elderly Chinese and Korean residents. Authorities have alleged that the facilities, together with nearby pharmacies, have generated enormous volumes of questionable Medicaid claims.
According to Oz, these taxpayer-funded social programs would not ordinarily receive government financing, noting that New York created a structure allowing them to qualify for Medicaid reimbursement. While Washington pays more than half of Medicaid’s costs, the remainder is funded by state and local governments.
“Normally, the government doesn’t pay for it. In New York, they’ve created a mechanism to pay for these programs,” Oz told host John Catsimatidis.
Oz went on to allege that organized Chinese criminal enterprises are behind many of the operations.
“These are run, we believe, under the auspices of the Chinese organized criminal groups that are also doing human trafficking in the East Coast.”
He did not identify any specific organizations or provide additional evidence supporting the allegation.
Accompanied during the tour by independent journalist Nick Shirley, Oz said he was struck by the unusually high concentration of pharmacies in Flushing, which he believes are exploiting Medicaid through fraudulent billing.
According to Oz, the alleged operation involves paying senior citizens for access to their Medicaid or Medicare identification cards, which are then used to submit false reimbursement claims.
“There are a dozen pharmacies on one block. Why? They’re all fake. They’re taking these Medicare beneficiary numbers and manufacturing huge businesses to fund illegal activities,” Oz said.
He claimed the fraudulent billing encompasses expensive medical equipment, unnecessary medications, and medical services that never occurred.
“They pretend they’re sending this really expensive wheelchair [to a patient],” he railed. “They pretend that they’re sending expensive random medications. They’re doing appointments they [patients] never go to. Tests they never get. Treatments they don’t receive or don’t need.
“And they begin to bankrupt all the legitimate people, because they make so much money … These programs have generated $2.1 billion against New York Medicaid.”
Oz argued that New York’s Medicaid structure not only permits such abuse but effectively encourages it, describing programs such as adult social day care and personal care services as a “feature” rather than merely a “flaw.”
Earlier this year, Oz launched a federal review of New York’s Medicaid program, which has the nation’s highest per-capita spending, alleging widespread waste, fraud, and abuse.
He also criticized New York’s Consumer Directed Personal Assistance Program, which allows family members to be compensated for caring for loved ones at home, saying the program has expanded beyond reasonable limits.
Oz further alleged that the state has allowed SEIU Local 1199 to organize personal care attendants, creating what he described as an improper financial and political arrangement.
“It’s a jobs program,” Oz claimed. “We learned that the unions are now unionizing these people, which means the federal government is paying salaries that go to union dues, and then the union dues fund the campaigns of the Democrats in the state. So now, you have political patronage on top of a jobs program,,
Taking a swipe at Gov. Kathy Hochul, Oz added:
“Is that a really smart thing to do if you lead the State of New York?”
He further accused state officials of relying on federal funding to sustain the system.
“They’re using the federal government as a piggy bank,” he added.
According to a recent analysis by the office of State Comptroller Tom DiNapoli, New York’s roughly $40 billion share of Medicaid spending has now exceeded the amount the state allocates to K-12 education.
Oz argued that government officials have failed to stop fraudulent activity.
“Fraud is rising because government wants it to exist,” he said.
He maintained that the Trump administration is moving aggressively to crack down on abuse and warned that states and those committing fraud have been put on notice.
Oz said the Centers for Medicare & Medicaid Services is working alongside the Department of Health and Human Services under Robert F. Kennedy Jr., as well as Vice President JD Vance, the IRS, and other federal agencies through the White House Task Force on Fraud to identify and eliminate Medicaid waste.
Gov. Hochul rejected Oz’s criticism, saying New York had already taken substantial action to combat fraud before the Trump administration took office.
“Well before the Trump administration even took office, Governor Hochul was leading efforts to root out waste, fraud and abuse – including sweeping CDPAP [Consumer Directed Personal Assistance Program], reforms that shut down hundreds of wasteful Medicaid middlemen and saved over $2 billion for state and federal taxpayers while protecting home care for those who need it,” a Hochul spokesperson said.
The governor’s office also accused the Trump administration of using fraud concerns as a pretext to reduce healthcare funding.
“New York will continue to work with the federal government to identify bad actors — but let’s be clear about the real goal for Donald Trump and Washington Republicans: eliminating programs that support our most vulnerable and ripping away healthcare from everyday New Yorkers.”
Hochul’s office also noted that New York’s Social Adult Day Care program was established in coordination with the Centers for Medicare & Medicaid Services through a federally approved waiver, adding that comparable programs operate in other states.
{Matzav.com}
