Dr. Oz, Vance issue six-month pause on new hospice, home health providers
The Trump administration announced that new provider enrollment to the nation’s Medicare program was paused Wednesday to review current enrollees for fraud. The announcement is the latest swing the government has taken against fraud and one of the first from the newly established White House Task Force to Eliminate Fraud.
The six-month pause would allow the Centers for Medicare and Medicaid to conduct “targeted investigations, deploy advanced data analytics and accelerate the removal” of providers from Medicare who are suspected of fraud. New enrollees aren’t the only ones affected, as CMS said changes in majority ownership would trigger an investigation.
The agency is solely responsible for regulating, controlling and administering Medicare providers.
The move doesn’t pause enrollments for individuals. CMS said in the release that the approach allows the agency to target fraudulent providers while retaining healthcare for patients.
“Today we’re shutting the door on fraud — preventing new bad actors from entering Medicare while we aggressively identify, investigate, and remove those already exploiting them,” Dr. Mehmet Oz, CMS administrator, said in a Wednesday release. “This is about protecting patients, restoring integrity, and safeguarding taxpayer dollars.”
The National Alliance for Care at Home, the leading advocacy organization for home healthcare, said in a press release that it supports efforts to root out fraud, but disagreed with CMS on how to do so. It advocates for targeted enforcement in areas rampant with fraud to prevent exhausting providers in areas with low fraud rates and provider shortages.
The alliance has sent recommendations to both the Trump and Biden administrations on how to best address fraud in home healthcare without affecting the quality of care providers give and patients receive.
“More importantly, an enrollment moratorium raises serious access-to-care concerns in areas where patient demand is growing or existing capacity is already strained, leading to longer wait times, reduced service availability, and fewer choices for patients – particularly in rural or underserved communities,” the alliance said.
The Trump administration has made government waste and fraud a primary focus. The Department of Government Efficiency brought the matter to the forefront with its aggressive spending reduction proposals. Attention shifted to social services as the administration changed the nation’s food stamp program, and later withheld assistance from Minnesota over allegations that Somalians were committing widespread fraud.
Vice President JD Vance also announced Wednesday the Trump administration is taking action against California by deferring roughly $1.3 billion in Medicaid reimbursements. Oz added that he’s seen a “rampant” level of healthcare and hospital fraud in California.
California Attorney General Rob Bonta said in a Wednesday post on X that it appeared his state is being targeted for political reasons.
“The Trump Administration is planning to defer over $1 billion in Medicaid funding for vital programs that helps seniors and people with disabilities remain safely in their homes,” Bonta said.
Vance targets states for Medicaid fraud
The White House’s fraud task force is also requiring all 50 states’ Medicaid programs to show proof they’re prosecuting fraud in their states.
“States like California, Hawaii and New York have completely not taken the fraud issue seriously in the Medicaid program,” Vance said. “For those states that refuse to get serious about fraud, we are going to turn off that anti-fraud money. And if we continue to find problems, we can turn off other resources within their state Medicaid programs as well.”
That’s not the case for California, Hawaii or New York, where the states have appointed either attorneys general or inspectors general to field and monitor fraud cases. Each state has updated its list of excluded providers, which means a practice or person cannot participate in that state’s Medicaid program.
According to Streamline Verify, a repository of healthcare compliance, California has 22,259 entries on its Medicaid exclusion list, the highest in the nation. By comparison, Texas has nearly 13,000, and New York excludes fewer than 9,000.
In New York, the Office of the Medicaid Inspector General handles fraud and referred 454 cases to the state Attorney General’s Office for possible prosecution, according to a 2024 annual report.
Gov. Gavin Newsom’s press office said shortly after Vance’s announcement that the state’s Department of Public Health requested an update from Oz’s office about enforcement actions in the Los Angeles area. The department sent the request on May 6 and has been awaiting a reply. CMS took action against 447 hospice and 23 home health agencies in the region.
The governor’s office said in a January news release that the state’s public health department revoked licenses for more than 280 hospices in the past two years and has about 300 additional ones under evaluation for revocation.
“Instead, Dr. Oz keeps saying a bigger and bigger number— first it was a few hundred, then it was 500, now it’s seemingly 800,” Newsom’s press office wrote on X. “Are they refusing to coordinate and share info with the state because they don’t actually believe in partnering? Or because they can’t back up the numbers that they are using?”
Ella Rae Greene, Editor In Chief
