MASSIVE: Oz Flags $100 Billion in Annual Medicare Fraud, Launches Nationwide State-Level Investigations

The Democrats told you there was no fraud. They told you the programs were running fine. They told you that anyone who raised concerns about Medicaid and Medicare waste was attacking the poor, attacking the vulnerable, attacking the sick. They lied.

Centers for Medicare and Medicaid Services Administrator Dr. Mehmet Oz has now confirmed what conservatives have been screaming for decades: an estimated $100 billion in taxpayer money is being stolen from American healthcare programs every single year, looted by organized criminal networks, foreign governments, politically connected fraudsters, and a vast ecosystem of fake providers that the Biden administration deliberately chose not to investigate. One hundred billion dollars. Every year. Gone.

Oz put the figure on the record in multiple public forums and is not walking it back. “Well, if you just look at the money that we pay the federal government for insurance, which is for Medicare and Medicaid and related programs, we think there’s about $100 billion of fraud, $100 billion now,” he told Fox News anchor Bret Baier.

He then connected it directly to the retirement security of every working American: “A lot of Americans who are working are concerned that Medicare won’t be there for them. They worry it won’t be solvent. If we’re able to take out the fraud in Medicare alone, we would double the life expectancy of the Medicare trust fund.” Double.

The fraud is so massive that eliminating it would double how long the program can survive. And the Biden administration knew and did nothing.

The specifics Oz has uncovered are not the kind of low-level billing errors that government bureaucrats point to when they want to minimize accountability. These are organized, systematic, industrial-scale criminal enterprises operating in plain sight.

Oz estimated that approximately 30 percent of hospice services in the entire country occur in Southern California, a statistical impossibility that has no explanation other than organized fraud.

“Literally one in $10 spent in the entire country in home health care is in L.A.,” he told Fox News. He then went and did something that no CMS administrator in history has apparently bothered to do before: he actually showed up.

“Yesterday, for example, I spent the predawn hours in Los Angeles busting into a swank neighborhood home owned by a doctor and a nurse who had been defrauding the hospice system there for millions of dollars,” he said.

The most explosive dimension of Oz’s investigation is who is running these fraud operations. This is not just opportunistic billing abuse by small-time providers.

Oz has explicitly stated his belief that foreign governments and organized foreign criminal networks are actively looting American healthcare programs.

He told the Washington Times that he suspects a Russian mafia presence in Los Angeles, a Chinese mafia presence in the Flushing neighborhood of Queens in New York, and possibly the Cuban government itself operating fraud schemes in South Florida. Foreign adversaries.

Stealing from Medicare. From American seniors. While the Biden administration’s Medicaid audit program was being gutted and its program integrity infrastructure was being stripped down to nothing.

The Minnesota investigation crystallized what the fraud ecosystem looks like at the state level and how deeply political the protection of that ecosystem became.

Oz appeared on The Katie Miller Podcast and described what he found in Minnesota as the weaponization of fraud. “When you’re elected to office, there’s some rules that you’re obliged to follow, but there’s always the opportunity for political patronage,” he said.

He went further, revealing that under federal law, every person signed up for Medicaid must also be offered a voter ID, characterizing the enrollment process as a voter enrichment and enrollment process. The fraud was not just stealing money. It was being used to build political machines funded by taxpayer healthcare dollars.

Oz described the institutional rot that allowed the $100 billion fraud to flourish. “The program that we have that audits Medicaid was gutted,” he said of the Biden years. “There wasn’t really a desire to focus on program integrity, such as who should be on the insurance program and who should not.” Gutted. Not underfunded. Not restructured. Gutted.

The Biden administration systematically dismantled the audit infrastructure that existed to catch exactly the fraud that Oz is now finding everywhere he looks. The question of whether that was incompetence or deliberate protection of a political constituency is one that congressional investigators are increasingly treating as rhetorical.

Oz’s investigation has moved to five states with the explicit threat that more are coming. Minnesota, California, Florida, New York, and Maine are all now under active scrutiny from CMS, with governors receiving letters demanding information within weeks and threatening federal action if they do not comply. The letters are not polite requests for cooperation. They are confrontational, adversarial demands for accountability from state governments that Oz clearly believes have been either complicit in or willfully blind to the fraud operating under their supervision. The 30-day deadline for all 50 states to submit provider revalidation plans raises the accountability pressure to a level the states have never faced before.

New York’s Medicaid program is a case study in what $100 billion in annual fraud looks like when a state government refuses to look for it. Oz has given Governor Kathy Hochul 30 days to answer 50 specific questions about a program that spends more than $100 billion annually, with per-beneficiary costs 36 percent above the national average and per-resident costs 80 percent above the national average.

Home health aide payments jumped by 65 percent year over year twice in a row with no corresponding increase in patient numbers. Adult daycare spending spiked by more than 100 percent in three months. A $68 million alleged kickback fraud scheme has already been uncovered by federal prosecutors. New York’s Medicaid program is not an outlier. It is the template.

The vice president’s fraud task force has backed Oz with the institutional weight of the entire administration. JD Vance announced a nationwide six-month moratorium on new Medicare enrollment for specific categories of durable medical equipment and other high-risk supplier types, a blunt enforcement tool aimed at cutting off new fraudulent enrollments in the supplier categories most heavily exploited by criminal networks.

The moratorium targets more than $1.5 billion in suspected fraudulent billing, a number that would have been the scandal of the decade in any prior administration and barely registers as a data point in the $100 billion annual fraud picture that Oz is documenting.

President Trump praised Oz in front of an audience of seniors at The Villages, Florida, on May 1, calling him the man who knows more about Medicaid, Medicare, and medical crap than any human being.

That endorsement from the president in front of the constituency that has the most direct personal stake in both the solvency of Medicare and the integrity of its administration matters enormously.

The seniors in that room paid into Medicare their entire working lives. The $100 billion being stolen from the program annually is money that belongs to them and to the program designed to care for them. Trump and Oz are delivering a message those seniors have been waiting decades to hear: someone is finally actually doing something about it.