The Trump administration on Wednesday announced a major new program to curb fraud in Medicare and Medicaid, unveiling a series of aggressive oversight and enforcement measures aimed at protecting patients, strengthening program integrity, and reducing federal spending.
Vice President J.D. Vance, Health and Human Services Secretary Robert F. Kennedy, Jr., and Centers for Medicare & Medicaid Services (CMS) Administrator Dr. Mehmet Oz announced the actions during a White House event, describing them as a decisive shift toward real-time fraud detection and accountability.
“For decades, Medicare fraud has drained billions from American taxpayers—that ends now,” Kennedy said, noting that CMS is replacing the traditional “pay and chase” model with a modernized “detect and deploy” strategy powered by advanced artificial intelligence tools.
Oz said the new strategy is designed to both cut off fraudulent payments before they occur and ensure that vulnerable Americans continue receiving the care they need.
The initiative builds on recent efforts to stop fraud that have already reaped results. For example, CMS actions targeting abusive pricing practices for wound care skin substitutes helped cut Medicare Part B premiums by $11 per month for beneficiaries. And in 2025, the government suspended $5.7 billion in suspected fraudulent Medicare payments, denied more than 122,000 claims that failed real-time medical necessity checks, and made 372 fraud referrals to law enforcement agencies involving $3.7 billion in billing.
Crackdown: Feds freeze millions in Medicaid funding to Minnesota
As part of the crackdown, CMS has deferred $259.5 million in federal Medicaid matching funds to Minnesota after identifying what the agency describes as serious concerns about questionable or unsupported claims. The deferral follows a previous notice issued to the state in January outlining deficiencies in program integrity oversight and requiring corrective action.
CMS’ review of Minnesota’s fourth-quarter FY 2025 Medicaid spending uncovered:
- $243.8 million in unsupported or potentially fraudulent claims
- $15.4 million in claims involving individuals without satisfactory immigration status
The agency noted rapid, unusually high spending increases in personal care services, home and community-based services, and other practitioner services. Federal officials warned that if the state fails to address the vulnerabilities, Minnesota could face more than $1 billion in additional federal deferrals over the next year.
Nationwide moratorium on DMEPOS supplier enrollment
To halt widespread fraudulent billing related to durable medical equipment and supplies, CMS issued a six-month national moratorium on new Medicare enrollment for certain by durable medical equipment, prosthetics, orthotics, and supplies (DMEPOS) suppliers. The sector has long been a target for bad actors, and CMS previously stopped more than $1.5 billion in suspected fraudulent billing during 2025.
The moratorium applies to:
- All new applications for Medicare enrollment
- Changes in majority ownership for existing suppliers
CMS also plans to publicly release information on providers and suppliers whose Medicare participation has been revoked, including their National Provider Identifier and reasons for removal—a transparency measure intended to help patients, payers, and insurers identify suspect actors.
CRUSH initiative seeks public input on future regulation
As part of the administration’s broader fraud strategy, CMS has issued a request for information (RFI) through its Comprehensive Regulations to Uncover Suspicious Healthcare (CRUSH) initiative. Stakeholders are encouraged to submit ideas on how CMS can strengthen efforts to prevent, detect, and address fraud and waste across Medicare, Medicaid, CHIP, and the Health Insurance Marketplace. Comments are due by March 20.