Republicans Push Major Crackdown on Medicare, Medicaid Fraud

Republican lawmakers are rallying behind a growing federal crackdown on Medicare and Medicaid fraud, arguing recent cases reveal abuse on a far larger scale than previously understood.

Last week, the Trump administration and the Department of Health and Human Services expanded efforts to detect Medicare and Medicaid fraud using AI and stricter audits after 15 people were accused of stealing over $90 million from Minnesota Medicaid programs.

Representatives like Beth Van Duyne (R-TX) have recently introduced legislation to strengthen Medicare oversight and crack down on fraudulent providers, which Rep. Pat Fallon (R-TX) said reveals how expansive this issue is.

“It's rampant, and it's out there, and we need to do something about it,” Rep. Fallon told Texas Politics. “We're talking about saving taxpayers hundreds of billions of dollars, possibly over a series of years; it'll be trillions of dollars.”

Rep. Fallon said that this fraudulent activity hurts the image of welfare programs like Medicaid and Medicare, pushing a false narrative that they aren’t doing what they’re supposed to.

“[This] doesn’t mean these programs don’t have value,” Rep. Fallon said. “It’s that these scumbags are stealing, and the people that you really and truly want to help aren't getting that help because of these scumbags.”

Rep. Jodey Arrington (R-TX) added that this false narrative also prevents others from acting to prevent fraud from happening out of fear that they’ll be vilified for critiquing these welfare programs.

“They'll have this false narrative that we're throwing poor people into the streets or taking food from the mouths of hungry children,” Rep. Arrington said in a recent interview on Squawk Box.

However, Rep. Arrington also said it is important to distinguish between fraud and improper payments, noting that a review of just 64 federal programs found $186 billion in improper payments, which can include errors, overpayments and ineligible claims.

“That's not the hundreds of billions in fraud that the Government Accountability Office is saying that we have,” Rep. Arrington said. “So those are two separate things.”

Despite recent warnings from himself and fellow lawmakers, Rep. Fallon said other members of Congress should be more committed to stopping this from happening.

“Don't look the other way. Don't say, well, we've got this much in fraud,” Rep. Fallon said. “You've got to be as committed to it as anyone to root it out.”