Program Integrity
Program integrity refers to the activities undertaken to prevent waste, fraud and abuse. Waste, fraud and abuse occurs in both private insurance and public health care programs such as Medicaid and Medicare. CCF experts mainly cover Medicaid program integrity.
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Governors and State Medicaid Directors Get a New Assignment from Dr. Oz: Quickly Recertify “High-Risk” Providers
On April 23, CMS Administrator Dr. Mehmet Oz sent a letter to all 50 Governors calling upon their Medicaid programs to “undertake a swift revalidation of Medicaid providers of services at high risk of waste, fraud, abuse, and corruption.” In the letter he requests that the Governor notify CMS within 10 business days (May 7)…
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States Work to Prevent Fraud Against Medicaid, Administration Uses Fraud to Attack Program
The first three months of 2026 have witnessed an unprecedented series of fiscal and rhetorical attacks on states by the White House and the political leadership at CMS, ostensibly about fraud against Medicaid. The focal point of these attacks has been Minnesota. On January 6, CMS notified the Governor of Minnesota that his state was out…
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Long-Standing State-Based Efforts to Combat Fraud Against Medicaid Continue to Improve
CMS Administrator Dr. Oz has been on a veritable press tour trumpeting the supposed rampant fraud in Medicaid and other government programs, which nationally he claims could add up to as much as $100 billion, presumably in a single year – though he hasn’t specified a timeframe. The White House recently established the Task Force…
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CMS Weaponizes Fraud Against Medicaid in Minnesota: The District Court Rules
On April 6, U.S. District Court Judge Eric Tostrud issued a decision in Minnesota v. Oz. The case was triggered by CMS’s deferral of $259 million in federal matching funds from the Minnesota Medicaid program on February 25. In response, the State filed suit on March 2 asking the court to block the CMS action…
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The White House Task Force to Eliminate Fraud: What’s at Stake for Medicaid
On March 19, President Trump issued an Executive Order Establishing the Task Force to Eliminate Fraud. The stated purpose of the Task Force, which is chaired by Vice President J.D. Vance, is to “coordinate and accelerate a comprehensive national strategy to stop fraud, waste, and abuse within Federal benefit programs, including programs administered jointly with…