CMS Admits Error in New York Medicaid Fraud Claim

The Centers for Medicare and Medicaid Services acknowledged this week that it used incorrect figures to accuse New York's Medicaid program of potential fraud, a mistake that prompted the launch of a federal investigation last month. CMS Administrator Dr. Mehmet Oz had claimed that the program provided personal care services, such as assistance with bathing, grooming and meal preparation, to roughly 5 million people in 2024, representing nearly three-quarters of the state's 6.8 million enrollees. The agency later clarified that the actual number was about 450,000 recipients, or 6 to 7 percent of enrollees.

Oz made the assertion in a social media video and a letter to New York Governor Kathy Hochul on March 3, stating that the high utilization rate was "unheard of" and calling for the state to "come clean" about its practices. He announced that CMS would open a probe into the program, citing concerns over billing and oversight. CMS spokesman Chris Krepich explained the error in a statement to reporters, saying the agency had misidentified how New York applies certain billing codes and has since refined its methodology. "CMS is committed to ensuring its analyses fully reflect...