Dr Oz alleges widespread fraud in New York's $100B Medicaid program, demands Hochul respond

New York's Medicaid program is being thoroughly examined by Centers for Medicare and Medicaid Services (CMS) Administrator Dr. Mehmet Oz, who claims there is evidence of widespread fraud. 

In a letter to New York Gov. Kathy Hochul Tuesday, Oz asked state officials 50 questions about the program and gave Hochul and her team 30 days to get the requested information to the Trump administration.

Oz asked that she and her team give CMS detailed information on "program integrity and provider screening and enrollment oversight within New York’s Medicaid program."

"Recent data reporting, federal prosecutions, and analyses raise serious concerns about New York’s oversight of personal care, home health, adult day care programming, non-emergency medical transportation (NEMT), and behavioral health services," Oz's letter addressed to Hochul and several state health officials read. "This evidence, combined with New York’s elevated per capita Medicaid spending and workforce utilization patterns that significantly exceed national norms, underscore the need for immediate investigation, corrective action, and enhanced transparency."

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"The data is clear: New York far outspends other states on its Medicaid program on a statewide and per beneficiary basis," he added.

In a video message, Oz said New York spends more than $100 billion a year on Medicaid, the second highest in the nation. He said New York’s average spending on each beneficiary is more than $12,500, 36% higher than the national average. 

"As a result, New York’s average Medicaid spending per resident was the highest in the country, nearly 80% higher than the national average," Oz said in the video.

"That alone demands scrutiny. But it gets worse. Personal care services, these help Medicaid patients do something that our families would normally do for us, like carrying groceries. New York State made the screening even more lenient by allowing problems like being ‘easily distracted’ to qualify for a personal care assistant. And that’s led to 45 billion in spending in just over two years," Oz added.

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Last year, Oz said, 5 million beneficiaries — nearly three out of four enrollees — received those personal care services. He argued that that level of utilization is "unheard of" and has made personal care services "the number one occupation in New York state." He argued New York has turned a program intended to help the most vulnerable into "a massive jobs program reimbursed by federal taxpayers."

Oz also argued that home health aide payments jumped by 65% year over year twice in a row, even though the number of patients did not increase "at that crazy high rate."

He said adult daycare spending spiked by more than 100% in the last three months while federal prosecutors found a $68 million alleged fraud scheme involving kickbacks at the adult care centers.

 "This isn’t about politics," Oz said. "It’s about protecting patients and protecting taxpayers. We owe New Yorkers transparency. We owe beneficiaries integrity. And we owe the American people accountability."

 "When the numbers don’t make sense, we ask hard questions, and we expect an honest answer," he said. "Governor Hochul has a month to share a reasonable corrective action plan to fix the fraud, waste and abuse in New York state or CMS will start deferring payments to protect Medicaid."

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A spokesperson for Hochul told Fox News Digital that she was leading efforts to get rid of waste, fraud and abuse in Medicaid before President Donald Trump's return to the White House. The spokesperson also said that Hochul's office would work with the administration to "identify bad actors." However, the spokesperson also classified CMS's probe as politically motivated.

"Well before the Trump administration even took office, Governor Hochul was leading efforts to root out waste, fraud and abuse — including sweeping CDPAP 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 spokesperson for Hochul told Fox News Digital.

"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," the spokesperson added.

The probe into the state's handling of Medicaid comes amid recent positive interactions between Trump and Democratic socialist New York City Mayor Zohran Mamdani. The two have exchanged niceties and met at the White House last week.

On Tuesday, Trump posted a photo of Mamdani in front of the Declaration of Independence in the Oval Office and said, "Zohran has come a long way embracing, of course, the Declaration of Independence while at the Oval Office — Big progress!"

Fox News Digital also reached out to Mamdani's office for comment.