Overview
- The White House, which on Wednesday deferred $1.3 billion in Medicaid reimbursements to California, warned more states could lose funds if they fail to tighten anti-fraud controls.
- CMS ordered a six-month nationwide pause on new Medicare enrollments for hospices and home-health agencies, targeting what it called high-risk billing categories for abuse.
- HHS’ inspector general notified all 50 attorneys general of a robust review of state Medicaid Fraud Control Units and Vice President J.D. Vance said units that fall short could lose federal support.
- During a Thursday visit to Bangor, Vance said a single migrant stole $15 million from Maine’s Medicaid program, but court records show the defendant is a U.S. citizen who owes $51,000 in restitution and an HHS audit he cited flagged documentation lapses rather than proven fraud.
- The crackdown also features DOJ strike forces and new state audits and revalidations, and prior deferrals in Minnesota have already sparked lawsuits that could shape how far these funding threats reach providers and patients.