Dr. Mehmet Oz Leads Medicaid Fraud Crackdown in NYC

FLUSHING, N.Y. — Dr. Mehmet Oz, Administrator of the Centers for Medicare and Medicaid Services, took action against suspected Medicaid fraud at two senior care centers in New York City. Accompanied by other federal health officials, he scrutinized the billing practices of these facilities in a move witnessed exclusively by Fox News Digital.

During his visit to Kent Senior Care and Evergreen Adult Day Care, both located in Flushing, Queens, Oz delivered warning letters alerting them of federal concerns over their billing methods. This visit was part of a larger effort by CMS that involved over 80 inspections and the distribution of similar warning letters to various providers around New York City.

The federal crackdown involved multiple agencies, such as the FBI, Department of Health and Human Services Office of Inspector General, and NYPD, among others. Though Oz’s team did not witness arrests, these actions were part of an extensive campaign to halt Medicaid from being improperly billed.

Visit to Kent Senior Care

Oz began his examination around 8:30 a.m. at Kent Senior Care, handing a letter to the director that noted issues with excessively high billings exceeding occupancy. The director countered that attendance would increase later in the morning.

There were discrepancies in billing practices, such as records showing full occupancy when the space allowed for 70 people. Questions also arose about wheelchair transportation services supposedly provided, despite no wheelchairs being observed at the time.

Oz further inspected recreational activities funded by Medicaid, questioning their necessity when compared to essential healthcare services such as surgeries and cancer therapies. Attendance records were also under scrutiny as seniors entered without signing in initially, leading to concerns about billing accuracy.

Examination of Evergreen Adult Day Care

At Evergreen, Oz again identified apparent billing irregularities, noting fewer attendees than claimed. While informed that up to 200 seniors visit some days, he observed significantly fewer present.

Discrepancies arose over wheelchair billing; officials were told no wheelchairs were used, then a small number was acknowledged. Attendance records with future dates also suggested potential pre-emptive or fraudulent documentation, heightening suspicions.

Allegations of Organized Crime

Dr. Oz alleged that organized criminal networks, including figures linked to the “Chinese mafia,” exploited Medicaid programs by paying seniors to feign participation. He claimed that the industry’s billing saw inexplicable spikes, pointing towards fraudulent activity supporting other crimes like money laundering and trafficking.

The crackdown aligned with a broader federal and state initiative against Medicaid fraud. Meanwhile, details on the outcome of searches or evidence remained under investigation, as officials continued their efforts to tackle fraud.