Fraud in federal health programs

Published 6:00 am Saturday, May 16, 2026

U.S. Rep. Brett Guthrie, R-Bowling Green, at South Warren High School on March 25, 2022.

In November 2024, the American people sent President Trump and a Republican trifecta to Washington to restore common sense and, importantly, take action to root out waste, fraud, and
abuse in the federal government. Over the past 16 months, government agencies, special task forces, and even independent reporters have exposed a pervasive and nearly institutionalized
level of fraud in programs across the federal government.

Like so many Americans, I have been outraged by the fraud that has come to light.

In Congress, I serve as the Chairman of the House Committee on Energy and Commerce, which has a broad jurisdiction of health care policy, including Medicaid and parts of Medicare. Last year, Republicans in Congress took action to close loopholes in these programs that enabled fraud and abuse as a part of the work we did in H.R. 1, the Working Families Tax Cuts. Early this year, my Committee continued this work, conducting a series of hearings to examine fraud that has occurred in these programs.

During a recent hearing, I asked Department of Health and Human Services (HHS) Secretary Robert F. Kennedy Jr. about the most shocking examples of fraud he has seen uncovered since he took office.

Secretary Kennedy highlighted the ways that, while in office, the Biden-Harris Administration enabled fraud to snowball in our government health programs. Some examples he gave included
the establishment of a program that knowingly paid out fraudulent claims, the significant reduction in the staff of the program integrity office, the way in which the Biden-Harris Administration prevented the government from validating eligibility for benefits more than once a year, and more.

Unfortunately, this isn’t a surprise. In our first hearing in this series, we heard from witnesses who work in various roles that identify and work to eliminate fraud in health systems across the
country. For nearly three hours, these witnesses explained common schemes that they see which negatively impact Medicaid and Medicare. Examples included:

People’s identities being stolen, and benefits being used to pay scammers, which often results in a denial of care when the patient actually needs it.

Scammers, including foreign entities, setting up fake Medicare and Medicaid accounts to receive illegitimate benefits.

Bad-faith health providers and fraudsters billing the taxpayer for services they never provided to patients.

We also conducted a hearing with Kimberly Brandt, who serves as the Deputy Administrator at the Centers for Medicare and Medicaid Services (CMS). During this hearing, Deputy
Administrator Brandt discussed the work CMS is actively doing to combat fraud in the system.

For example, CMS has uncovered schemes in which scammers will fraudulently bill Medicare for durable medical equipment, genetic testing, and clinical laboratory testing that are either
medically unnecessary or were never provided. They have also shockingly uncovered schemes in which Medicare beneficiaries without terminal illnesses are being unknowingly signed up for
hospice care. Bad actors are undermining Americans’ trust in these programs and risking the integrity of Medicaid and Medicare; it cannot be allowed to continue.

The fact is, billions of taxpayer dollars are being scammed from federal health programs annually, and it is negatively affecting the Medicare and Medicaid programs for those who need
it most: seniors, expectant mothers, children, and people with disabilities.

Rather than seeing this as an opportunity to work across the aisle and find bipartisan ways to end fraud, my Democrat colleagues have spent the past months fighting against transparent
investigations, undermining the important work carried out by this Committee… even wasting time debating the definition of “fraud.” This is sadly all an attempt to cover up the fact that the
policies of the Biden-Harris Administration enabled fraud to run rampant for years. Some things you just can’t make up.

From California, to Minnesota, to New York, fraud in federal health care programs have created real consequences for the most vulnerable Americans who rely on Medicaid and Medicare. To
preserve the integrity of these important programs, we must close loopholes, prosecute bad actors, and safeguard the most vulnerable in our communities.

I am grateful for the work the Trump Administration has already undertaken to combat the rampant fraud in federal health programs, and I look forward to continuing to collaborate with
my colleagues in Congress to end this concerning trend to guarantee that benefits are available to those who need them most.

— Congressman Brett Guthrie serves as Chairman of the House Committee on Energy and Commerce, which has a broad health care jurisdiction, including Medicaid and some Medicare policy.