Dr. Oz Leads Crackdown on Suspected Medicaid Fraud in NYC

Dr. Mehmet Oz, the Centers for Medicare and Medicaid Services Administrator, took action against two senior care centers in New York City over concerns about Medicaid fraud. Accompanied by senior federal officials, he visited Kent Senior Care and Evergreen Adult Day Care in Flushing, Queens. This effort was part of a larger crackdown involving the FBI, NYPD, and other agencies.

The facilities received warning letters highlighting worries over their billing practices. These visits were among over 80 conducted by CMS officials across the city. Fox News Digital joined Oz as he questioned employees about their billing records.

Dr. Oz expressed suspicion about the billing processes at these facilities. He noted, “The whole experience was suspicious,” referring to the broad crackdown that involved multiple enforcement actions. However, specific actions like arrests or search warrants were not observed during the visits.

Confrontation at Kent Senior Care

At Kent Senior Care, Dr. Oz personally handed a letter to the director, questioning the facility’s billing. He pointed out the discrepancy between the billing records and actual attendance, saying, “The bills are much higher than they should be.” The director explained that more seniors would arrive as the day progressed, but Oz remained skeptical. The maximum occupancy sign stated capacity for 70 people, but Oz claimed billing suggested full occupancy.

Concerns included billing for seniors attending five days, though they more frequently attended two or three days. Additionally, specialized transportation services for wheelchairs raised red flags. Although the facility reported wheelchair use, Fox News Digital did not observe any during the visit. The director suggested previous records may have been copied incorrectly.

Mahjong and Other Activities

Dr. Oz questioned the appropriateness of taxpayer dollars being used for activities like mahjong. The director defended the game, highlighting its benefits for seniors’ memory and social interaction. Oz countered, questioning the allocation of federal tax dollars meant for essential medical services.

Attendance Irregularities

Further concerns arose when seniors entered without signing in, despite the director’s insistence on documentation. Oz noted inconsistencies in attendance records, adding, “People were just walking in there without signing anything.” Some seniors later signed in upon arriving.

Evergreen Adult Day Care

At the second stop, Dr. Oz confronted a manager over billing discrepancies. The manager claimed attendance figures that did not match observed numbers. The manager’s estimates conflicted with what Oz saw, causing him to question how they justified the billing levels. Additionally, wheelchair-related billing was probed, with the manager eventually admitting a small number of users after an initial denial.

Allegations of Organized Crime

During his visits, Dr. Oz alleged that organized crime was exploiting Medicaid-funded programs. He mentioned networks potentially paying seniors to falsely attend facilities, although specific criminal affiliations were not detailed.

The federal crackdown was partly in response to unexpected billing spikes in the industry, with annual expenditures nearing $1 billion. Oz claimed fraud accelerated during the COVID-19 pandemic and criticized prior administration’s oversight.

Governor Kathy Hochul supported the fraud crackdown, involving state health officials and law enforcement. The investigation into facilities and individuals continues, with specifics yet to be disclosed.

Fox News Digital captured the confrontations and questions raised by Dr. Oz as part of these efforts to ensure Medicaid integrity.