In conjunction with an August 4 press conference in Philadelphia, the Trump Administration announced expanded Medicaid fraud enforcement efforts, including new charges related to Medicaid home care fraud and the expansion of the Northeast Health Care Fraud Strike Force into the Philadelphia region. The initiative involves coordination among the U.S. Department of Justice, the FBI, the Pennsylvania Attorney General, and the U.S. Attorney’s Office for the Eastern District of Pennsylvania.
Administration officials emphasized a broader government-wide strategy to detect and prosecute healthcare fraud. CMS Administrator Mehmet Oz and Deputy Administrator Kim Brandt highlighted recent CMS program integrity activities, including actions targeting fraudulent providers and concerns about utilization trends in personal care services and Applied Behavioral Analysis (ABA) services. CMS also announced the release of a new state toolkit related to ABA oversight.
LeadingAge supports strong enforcement against fraud and abuse and agrees that bad actors should be held accountable. At the same time, concerns persist that the broader messaging surrounding these announcements may contribute to negative perceptions of home and community-based services (HCBS). Public discussion that focuses heavily on fraud risks can inadvertently undermine confidence in essential HCBS programs that serve older adults and individuals with disabilities.
LeadingAge is also concerned that the messaging accompanying the ABA toolkit may suggest that program growth alone is evidence of misuse, reinforcing broader narratives that question the value and integrity of HCBS. These concerns are heightened in the context of recent federal policy discussions related to community integration and interpretations of Olmstead.
The administration’s press release and press conference materials are available online for additional detail.