Common Sense Solutions to Fight Fraud
Yesterday, the Centers for Medicare and Medicaid Services (CMS) sent an eight-page letter to Gov. Kathy Hochul (D-NY) about potential fraud in that state’s Medicaid program. The letter cited CMS data to observe that the state’s “average Medicaid spending per resident was the highest in the country—nearly 80% higher than the national average.”
Moreover, much of that high spending is concentrated in specific high-risk areas. The letter notes that, over two-plus years (2023, 2024, and part of 2025), the state spent $44.6 billion—yes, that’s billion with a “B”—on personal care services billed hourly. As I have previously noted, New York think-tanks have documented the rapid growth of “jobs” in the personal care sector in the state, raising questions of whether or not all this “employment” is legitimate. Even Hochul herself admitted as much in 2024:
I’m telling you right now, when you look on TikTok and you see ads of young people saying, “Guess what, you can make $37 an hour by sitting home with your Grandma. You know, here’s how you sign up,” it has become a racket.
Given these dynamics, the 50 questions CMS sent to New York seem not just perfectly reasonable, but necessary to get a grip on potential fraud that has seen spending skyrocket out of control.
But fighting fraud shouldn’t be a partisan issue—far from it. Lest Democrats complain that the agency is singling out blue states, why doesn’t CMS send carbon copies, or slightly modified versions tailored to specific states’ circumstances, of the New York letter to ALL state Medicaid departments? Red and blue states alike should all benefit from increased accountability—to the federal government, and to their taxpayers—about where families’ hard-earned dollars are going.
Kudos to CMS for asking hard questions about Medicaid fraud in New York, along with Minnesota. That makes two states down, and 48 more (plus the District of Columbia!) to go.