NEW YORK (AP) 鈥� President Donald Trump’s administration this week acknowledged it made a significant error in figures it used to help justify into New York鈥檚 Medicaid program, a glaring mistake that undercuts a federal campaign to tackle waste, mostly in Democratic-led states.
The error, which the administration admitted first to The Associated Press, prompted health analysts to question how many of the Republican administration鈥檚 sweeping anti-fraud efforts around the country were based on faulty findings. One of a few mischaracterizations it made about New York’s Medicaid program, it also reflected a common criticism that鈥檚 been made of Trump鈥檚 second administration 鈥� that it tends to attack first and confirm the facts later.
鈥淭hese numbers could have been cleared up in a phone call, so it鈥檚 really slapdash,鈥� said Fiscal Policy Institute senior health policy adviser Michael Kinnucan, whose called attention to the Trump administration鈥檚 inaccurate claim.
The mistake appeared in comments made last month by , the administrator of the Centers for Medicare & Medicaid Services, in a social media video and in a letter to New York鈥檚 Democratic governor announcing the fraud investigation.
Oz claimed that New York鈥檚 Medicaid program last year provided some 5 million people with personal care services, which assist people in need with basic activities like bathing, grooming and meal preparation. That would add up to nearly three-fourths of the state鈥檚 6.8 million Medicaid enrollees.
鈥淭hat level of utilization is unheard of,鈥� Oz said in the video, adding in his post that New York needs to 鈥渃ome clean about its Medicaid program.鈥�
But the real number of New Yorkers who used those services last year was about 450,000, or between 6% and 7% of total enrollees, CMS spokesman Chris Krepich told the AP this week. He said the agency misidentified New York鈥檚 approach to applying billing codes and had since refined its methodology.
鈥淐MS is committed to ensuring its analyses fully reflect state-specific billing practices and will continue to work closely with New York to validate data and strengthen program integrity oversight,鈥� he said in an emailed statement.
Krepich said the probe was ongoing as the administration still has concerns with New York鈥檚 oversight of personal care services and the Medicaid program and is reviewing the state鈥檚 response to last month鈥檚 letter. CMS had raised other flags about New York鈥檚 program, including that it spends more per beneficiary and per resident than the average state, has high personal care spending and employs so many personal care aides that the job category is now the largest in the state.
Health analysts said the state’s high spending reflected both high costs for services in New York and a policy choice to provide robust at-home care. Cadence Acquaviva, senior public information officer for the New York Department of Health, called Oz鈥檚 initial mischaracterizations 鈥渁 targeted attempt to obscure the facts.鈥�
鈥淣ew York State remains committed to protecting and preserving vital Medicaid programs that deliver high-quality services to New Yorkers who depend on them,鈥� she said.
In a statement, a spokesperson for Gov. Kathy Hochul said, 鈥淭he initial claim by CMS was patently false, and we are glad they now admit it.”
鈥淕overnor Hochul has been clear that New York has zero tolerance for waste, fraud and abuse in Medicaid, or any other state programs, and will continue her efforts to root out bad actors, protect taxpayer dollars, and safeguard the critical programs that New Yorkers rely on,鈥� spokesperson Nicolette Simmonds said.
New York probe is part of a larger crackdown
The Trump administration鈥檚 investigation into New York comes as it has similarly approached at least four other states, including , , Maine and Minnesota, with investigations into potential health care fraud. The anti-fraud effort appears to be expanding as voters in the upcoming midterm elections say they鈥檙e concerned about affordability.
Trump last month signed an executive order to create an anti-fraud task force across federal benefit programs led by Vice President JD Vance. As part of that project, Vance announced the administration would temporarily halt to Minnesota over fraud concerns, a move over which the state has since .
Kinnucan, the analyst with expertise in New York鈥檚 Medicaid program, said he鈥檚 concerned that the Trump administration鈥檚 adversarial approach to targeting fraud in some states 鈥減oliticizes鈥� a conversation that should be a team effort.
鈥淲e want to think collaboratively among all the stakeholders in the program about how we can actually fix it,鈥� Kinnucan said. 鈥淲e don鈥檛 want to have fraud be this political football.鈥�
Oz made other claims New York advocates say are inaccurate
In his video, Oz made at least two other claims about New York that Medicaid advocates and beneficiaries say distorted the facts.
In one instance, he said the state recently made its screening for personal care eligibility 鈥渕ore lenient by allowing problems like being 鈥榚asily distracted鈥� to qualify for a personal care assistant.鈥�
Rebecca Antar, director of the health law unit at the Legal Aid Society, said the opposite was true 鈥� that the state in a rule change that went into effect last September instead made its program requirements more stringent. She said being 鈥渆asily distracted鈥� doesn鈥檛 appear anywhere among them.
Krepich said the administrator was referring to whether New York鈥檚 standard for personal care services was 鈥渟ufficiently rigorous.鈥�
鈥淲hen standards are overly permissive, it risks diverting resources away from individuals with the highest levels of need and placing long-term pressure on the sustainability of the Medicaid program,鈥� he said.
Oz in the video also referred to personal care services as 鈥渟omething that our families would normally do for us, like carrying groceries.鈥�
Kathleen Downes, a 33-year-old who has quadriplegic cerebral palsy and uses personal care services in New York鈥檚 Nassau County, said she was offended by the notion that all Medicaid beneficiaries have family members who are willing and able to help.
Downes, who has been disabled since birth and needs personal care help for things like showering, using the toilet and eating, said she hires both her mother and outside assistants for personal care services, so her aging mother doesn鈥檛 have to take on those tasks full time. She said her mother did the labor unpaid for years, precluding her from pursuing other career opportunities.
鈥淗e鈥檚 assuming that everybody wants to and can just do it for free forever,鈥� Downes said. “And that鈥檚 not feasible for a lot of people.鈥�
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Associated Press writer Anthony Izaguirre contributed to this story.
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