The Trump administration announced late Wednesday new steps it says are designed to crack down on fraud.
The new push, which comes just one day after President Donald Trump highlighted the White House's focus on fraudulent behavior across multiple social programs, includes three key prongs. In the first piece, the Centers for Medicare & Medicaid Services (CMS) said it would hold back $259.5 million in Medicaid funding for the state of Minnesota.
The agency said it notified the state in January that it intended to withhold the funds while Medicaid officials addressed program integrity concerns held by the feds.
Fraud in Minnesota in particular has been a political focus for the administration, with the backdrop of the federal crackdown on immigration in the state, though officials said Wednesday that it's not the only state where fraud is a concern, per a report from Fox News.
Based on an agency review, the CMS said $243.8 million of the withheld funding was flagged as "unsupported or potentially fraudulent" claims, while $15.4 million was linked to claims for individuals "lacking a satisfactory immigration status."
The CMS said the review found unexpectedly high spending and rising costs related to several service lines, including personal care services and home health. If officials in the North Star State are unable to show program integrity improvements or prove these claims were viable, the CMS said it could defer as much as $1 billion in funds over the next year.
"CMS also continues to intensely oversee Minnesota’s efforts to carry out its corrective action plan to address the underlying causes of fraud, waste, and abuse within the state," according to a press release.
In addition, the CMS said it is taking aim at fraudulent billing conducted by durable medical equipment companies, saying a six-month moratorium on new Medicare enrollment for certain DME suppliers avoided $1.5 billion in fraudulent bills.
During the moratorium, the CMS was able to work toward addition safeguards to addressing fraudulent billing in this space. The agency said it plans to publish a list of which provider or suppliers have had their ability to operate in Medicare revoked, with details on why, to offer greater transparency to patients and insurers.
As it continues to put a focus on addressing fraud, waste and abuse in healthcare, the CMS said it is also seeking feedback on additional fraud prevention strategies it could use in a future rule as part of the Comprehensive Regulations to Uncover Suspicious Healthcare, or CRUSH, initiative.
The CMS is looking for strategies across different programs, including Medicare, Medicaid, the Children's Health Insurance Program and the Affordable Care Act's insurance exchanges. The agency said stakeholders can submit feedback that leans on existing programs as well as ideas for new regulatory approaches.
Vice President J.D. Vance is spearheading the effort alongside Department of Health and Human Services Secretary Robert F. Kennedy Jr. and CMS Administrator Mehmet Oz, M.D. In the press release, Oz said the "proactive approach will help us crush fraud, protect taxpayer dollars and make sure the vulnerable Americans who depend on our programs get the care they need.”
“CMS is done trying to catch fraudsters with their hands in the cookie jar—instead, we’re padlocking the jar and letting them starve,” Oz said.