Dr. Oz Leads Federal Crackdown on Suspected Medicaid Fraud at NYC Day Care Centers

Centers for Medicare and Medicaid Services Administrator Dr. Mehmet Oz personally confronted employees at two New York City senior care centers on Tuesday as part of a large-scale crackdown on suspected Medicaid fraud. Oz, accompanied by federal and local law enforcement officials, visited Kent Senior Care and Evergreen Adult Day Care in Flushing, Queens, to deliver warning letters regarding questionable billing practices.

The visits were part of a coordinated effort involving the FBI, the Department of Health and Human Services Office of Inspector General, and the NYPD. CMS officials conducted more than 80 visits across New York City on Tuesday, issuing warning letters to various providers.

At Kent Senior Care, Oz directly questioned the facility's director about billing records that appeared to inflate attendance numbers. "The bills are much higher than they should be," Oz stated, noting that the facility's occupancy did not seem to match the billing claims. He pressed the director on discrepancies, particularly regarding charges for specialized transportation for seniors using wheelchairs, which Oz observed were not apparent during his visit.

Concerns were also raised about seniors entering the facility without signing in, a practice Oz observed and which appeared to change once his team arrived. He questioned the validity of attendance records used for Medicaid billing.

During his visit to Evergreen Adult Day Care, Oz spoke with a floor manager about attendance figures that he found inconsistent with the number of seniors present. He also examined attendance records that appeared to include future dates, raising further questions about the accuracy of the facility's documentation.

Oz suggested that organized criminal networks might be exploiting Medicaid-funded programs, potentially using proceeds from fraud to finance other illicit activities. He alluded to allegations of individuals connected to organized crime paying seniors to participate in fraudulent billing schemes. While Oz did not name specific organizations, he characterized the broader scheme as a "clubhouse for crime."

New York Governor Kathy Hochul acknowledged the crackdown, describing it as a "massive effort to combat fraud and abuse" in Medicaid. State health officials collaborated with federal and local law enforcement in targeting social adult day care programs suspected of fraud. Specific details regarding other targeted facilities, individuals involved, or evidence gathered were not immediately available as investigations are ongoing.