Federal health officials have conceded they made a major data error when launching a fraud investigation into New York’s Medicaid program, raising questions about the accuracy of similar probes targeting other states across the country.
The mistake involved wildly inflated numbers that Dr. Mehmet Oz, who leads the Centers for Medicare & Medicaid Services, used to justify the investigation. In a social media video and official correspondence to New York’s governor last month, Oz stated that approximately 5 million New Yorkers received personal care services through Medicaid in the previous year.
“That level of utilization is unheard of,” Oz declared in his video, demanding that New York “come clean about its Medicaid program.”
However, federal officials now admit the actual figure was roughly 450,000 people, representing just 6% to 7% of the state’s total Medicaid recipients rather than the three-quarters that the original claim suggested.
CMS spokesperson Chris Krepich explained this week that the agency incorrectly interpreted New York’s billing code system and has since updated its analysis methods. “CMS 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,” Krepich stated in an email.
The blunder has drawn criticism from policy experts who question the thoroughness of the administration’s anti-fraud initiatives. “These numbers could have been cleared up in a phone call, so it’s really slapdash,” commented Michael Kinnucan, a senior health policy adviser at the Fiscal Policy Institute who first highlighted the administration’s incorrect figures.
Despite acknowledging the error, federal officials say their investigation continues, citing other concerns about New York’s Medicaid spending and oversight practices. They point to higher-than-average costs per beneficiary and the state’s substantial investment in personal care aide positions.
New York health officials have pushed back against the characterizations. Cadence Acquaviva from the state Department of Health described Oz’s original statements as “a targeted attempt to obscure the facts.” She emphasized that “New York State remains committed to protecting and preserving vital Medicaid programs that deliver high-quality services to New Yorkers who depend on them.”
Governor Kathy Hochul’s office welcomed the federal admission of error. “The initial claim by CMS was patently false, and we are glad they now admit it,” said spokesperson Nicolette Simmonds. She added that Hochul “has been clear that New York has zero tolerance for waste, fraud and abuse in Medicaid, or any other state programs.”
The New York investigation is part of a broader federal effort targeting potential healthcare fraud in multiple states, including California, Florida, Maine, and Minnesota. President Trump recently established an anti-fraud task force headed by Vice President JD Vance, which has already moved to suspend $243 million in Minnesota Medicaid funding over fraud allegations.
Critics argue this approach creates unnecessary confrontation in what should be collaborative oversight efforts. “We want to think collaboratively among all the stakeholders in the program about how we can actually fix it,” Kinnucan explained. “We don’t want to have fraud be this political football.”
Beyond the numerical error, advocates say Oz made additional misleading claims about New York’s program. He suggested the state had relaxed eligibility requirements to include conditions like being “easily distracted” as grounds for personal care assistance.
Rebecca Antar, who directs the health law unit at the Legal Aid Society, contradicted this assertion, explaining that New York actually tightened its requirements in September and that “easily distracted” doesn’t appear in the criteria.
Oz also characterized personal care services as tasks “that our families would normally do for us, like carrying groceries,” a description that upset program participants like Kathleen Downes, a 33-year-old Nassau County resident with quadriplegic cerebral palsy.
Downes, who requires assistance with basic activities like bathing and eating, said the comment overlooks the reality that many people lack family members who can provide such intensive care. “He’s assuming that everybody wants to and can just do it for free forever,” she noted. “And that’s not feasible for a lot of people.”
