Alleged Fraud Turns Public Benefits Into Private Gain

More than 80 social adult day care providers received warning letters over questionable Medicaid billing as federal and New York City agencies searched sites across the city. The investigation targets alleged schemes involving taxpayer-funded health programs. Separate cases accuse companies and individuals of billing public programs or collecting money through fraud.

Public programs under investigation

On Tuesday, Oct. 20, Centers for Medicare & Medicaid Services Administrator Dr. Mehmet Oz, the FBI, NYPD and other agencies delivered letters and searched social adult day care centers in New York City. The FBI said agents and other law enforcement agencies were active in Queens, Staten Island, Brooklyn and other locations as part of ongoing federal investigations.

Oz cited alleged irregularities: low attendance despite high Medicaid billing, questionable wheelchair-transportation charges, seniors entering without signing in, inconsistent attendance claims and sign-in sheets with future-dated entries. The FBI, HHS Office of Inspector General, NYPD and other agencies took part in the investigation.

A 27-minute documentary, “War on Fraud,” follows Oz across the country and presents Trump administration investigations into alleged healthcare fraud involving Medicare, Medicaid, hospice care and other programs. Fox News Digital said it first obtained the film, which was scheduled for release Wednesday at 4 p.m. ET on Oz’s X account. HHS Secretary Robert F. Kennedy Jr. and CMS Deputy Administrator Kim Brandt also appear.

“All these programs come back to one basic issue: Fraudsters and criminals don't give a s--- about you. They want your money, and they will walk all over your health, sacrifice your life and betray society's trust to get your hard-earned money,” Oz says in the video.

Billing, alleged profits and public costs

The film also identifies hospice care as a potential fraud area. Oz cited roughly 2,000 hospice providers in the Los Angeles area, a concentration he said raised concerns about fraudulent billing. He alleged Russian organized-crime groups took part in some suspected operations. Patients, he said, were sometimes enrolled under false pretenses, including false declarations that they were terminally ill. Such enrollment could limit patients’ access to treatment while operators billed Medicare for services under false pretenses, Oz said.

Federal prosecutors also allege medical-equipment companies in Delray Beach, Florida, joined a $3.7 billion Medicare-fraud scheme, billing for equipment patients hadn’t requested or needed. The alleged ringleader fled the country. Turkish authorities captured the person and returned them to South Florida to face federal charges.

In Flushing, Queens, Oz called a cluster of businesses, including a social adult day care center, pharmacy and medical center, a “clubhouse for crooks.” He alleged the businesses took seniors’ identification numbers and used them to submit fraudulent bills. Operators recruit seniors, Oz said, “get them in, game the system and they use their ID numbers to charge everybody, 'which means they are charging you.'”

Other cases and enforcement

Minnesota has drawn the administration’s attention in its wider government-benefits fraud crackdown since the $250 million “Feeding Our Future” scandal gained national attention in 2022 and led to a wave of federal convictions. The White House Task Force on Fraud, led by Vice President JD Vance, has joined Oz in publicizing alleged schemes.

In Massachusetts, prosecutors accused U.S. citizen Jennifer Gonzalez of arranging sham marriages for immigrants seeking legal status. Leah Foley, the U.S. attorney for the Massachusetts District, said Gonzalez allegedly collected up to $40,000 per marriage and arranged as many as 20 marriages a year over the last decade. The alleged conspiracy “netted her $6 million during the course of the alleged scam,” Foley said.

Foley said Gonzalez also applied for and received more than $124,000 in SNAP benefits from 2019 through 2026, allegedly failing to report income from the marriage business or list other household members. The Justice Department said Gonzalez, her 31-year-old secretary, Amara Pugh; Jessica Tavares, 31; Erica Daniels, 29; and Jaylin Hill, 26, were accused in the case. Gonzalez, Pugh, Tavares and two other alleged conspirators were arrested Wednesday morning. Hill was already in state prison for a gun offense. The Justice Department described the case as an allegation.