Centers for Medicare and Medicaid Services (CMS) Administrator Dr. Oz conducted unannounced visits to two senior care facilities in Flushing, Queens, on Tuesday, initiating a broader federal effort to address alleged billing irregularities and fraud within social adult day care programs. Accompanied by senior federal health officials, Dr. Oz presented letters to the directors of Kent Senior Care and Evergreen Adult Day Care, signaling federal scrutiny into their billing practices.
"You’re getting this letter from the U.S. Government because we don’t believe you." Dr. Oz, Administrator for Centers for Medicare and Medicaid Services
The visits are part of a citywide push where CMS officials have delivered letters flagging billing concerns to more than 80 providers. At Kent Senior Care, which Dr. Oz visited around 8:30 a.m., he told the director, "The bills are much higher than they should be. The billing is for more people. It doesn’t look very crowded here." A posted occupancy sign at Kent listed a maximum of 70 people, while Dr. Oz suggested billing records indicated constant full occupancy. The director maintained that billing matched attendance and that participants signed attendance sheets. Dr. Oz cited records showing five-day-a-week attendance for some seniors, which the director countered by stating many attended only two or three days. "You’re getting this letter from the U.S. Government because we don’t believe you," Dr. Oz responded. Fox News Digital, which accompanied Dr. Oz, reported seeing several seniors enter Kent without immediately signing attendance sheets, with staff later instructing them to sign in. Dr. Oz remarked, "People were just walking in there without signing anything. And then after I showed up and he saw what we were doing with my team, he started collecting these documents to be signed."
Further questions arose regarding charges for specialized wheelchair transportation. Dr. Oz noted the absence of wheelchairs during his visit, although seniors with walking aids were observed. An accompanying official questioned whether the billed services were delivered and by which company. The director explained that some participants had mobility difficulties, such as those recovering from strokes, and that wheelchairs were kept available. He suggested that billing codes for wheelchair use might have been copied from older files without updates. Dr. Oz also questioned the use of federal taxpayer funds for activities like mahjong, asking if it was for "life-saving heart surgery" or "new therapies for cancer" instead. The director defended the game as beneficial for seniors' socialization, dexterity, and memory, particularly for those with cognitive challenges.
At Evergreen Adult Day Care, similar discrepancies emerged. Dr. Oz estimated approximately 25 people were present in the main room, while a floor manager stated figures of 150 to 200 seniors on various days. The manager attributed the lower count during the visit to seniors being in classes or out for appointments. "The numbers don’t seem to add up," Dr. Oz stated. The issue of wheelchair charges also resurfaced, with the manager initially denying any participants used wheelchairs before acknowledging a small number did. Dr. Oz also examined Evergreen's attendance books, where Fox News Digital reported seeing entries for October 22 and 23, dates that had not yet occurred. Dr. Oz labeled these entries as "fraud," though the outlet could not immediately determine if they were completed records or advance schedules.
Following the visits, Dr. Oz summarized his observations, stating, "The whole experience was suspicious. We know from the billing here that there’s no way this business is running in the way that they claim to be running without something being wrong. Is it an innocent mistake? A hundred times in a row, I don’t think so." He detailed that the broader crackdown involves multiple federal and local agencies, including the FBI, the Department of Health and Human Services Office of Inspector General, and the NYPD. Dr. Oz indicated that authorities are making arrests, executing search warrants, and working to block certain operators from billing Medicaid.
Dr. Oz further alleged a significant increase in billing across the industry, with annual spending approaching $1 billion. He claimed that organized criminal networks exploit these programs, specifically alleging that individuals connected to the "Chinese mafia" offered seniors between $1,000 and $1,200 to participate in fraudulent billing schemes for services never rendered. He also suggested that fraudulent Medicaid proceeds support money laundering and human trafficking. Fox News Digital reported that it had not independently verified these broader allegations or established any direct link to Kent or Evergreen. Social adult day care programs are designed to provide activities, supervision, meals, and social support to eligible seniors, with Medicaid payments contingent on applicable rules, participant eligibility, and documented service delivery.
