Centers for Medicare & Medicaid Services (CMS) Administrator Dr. Mehmet Oz recently outlined the Trump administration's ongoing initiatives to combat improper federal payments and healthcare fraud. Speaking on Fox News' "Saturday in America," Dr. Oz detailed a significant Medicaid fraud conviction in Brooklyn, New York, and raised concerns regarding subsidized health insurance enrollment figures in Florida. These efforts underscore a broader administrative focus on safeguarding taxpayer money and ensuring the integrity of federal health programs.
"If we could just take the fraud out of Medicare, we would double the life expectancy of the Medicare trust fund." Dr. Mehmet Oz, CMS Administrator
The Brooklyn case involved Zakia Khan, 55, who was sentenced to 76 months in prison this week by U.S. District Judge Natasha Merle. Khan, the owner of two social adult daycare centers, Happy Family and Family Social, along with a home care company, was found guilty of orchestrating a scheme that submitted approximately $64 million in Medicaid claims. Prosecutors from the U.S. Attorney’s Office for the Eastern District of New York stated that Medicaid paid out roughly $56 million of these claims between October 2017 and July 2024. Khan pleaded guilty in August 2025 to conspiracies involving health care fraud and defrauding the U.S. government through illegal kickbacks.
Evidence presented during the case indicated that Khan paid kickbacks to Medicaid recipients to facilitate billing for services that were never provided. Undercover video reportedly showed Khan counting cash for an officer posing as a Medicaid recipient, illustrating the direct nature of the fraudulent activity. In addition to her prison sentence, Khan was ordered to pay more than $56 million in restitution and forfeit $5 million in proceeds. The forfeited assets included two properties, cash, and gold jewelry seized from her residence, according to official announcements. Dr. Oz cited this prosecution as a prime example of funds being diverted from programs intended to support vulnerable patients.
Beyond individual criminal prosecutions, Dr. Oz addressed the administration's broader strategy to prevent fraudulent payments before they are disbursed. He noted that CMS had successfully prevented approximately $42 billion in improper payments "just by not shipping the money out of the building" earlier this month, as reported by Townhall. Dr. Oz also provided an estimate that Medicare and Medicaid collectively experience approximately $100 billion in annual theft. These figures highlight the scale of the challenge and the potential for significant savings through enhanced anti-fraud measures. He emphasized the long-term benefits of these efforts, stating, "If we could just take the fraud out of Medicare, we would double the life expectancy of the Medicare trust fund."
Turning his attention to the Affordable Care Act (ACA), often referred to as Obamacare, Dr. Oz expressed concerns about enrollment figures in Florida. He stated that enrollment in what he termed Obamacare's "free category" was five times larger than the population estimated to be eligible for that subsidy tier. In a social media statement, he referenced an analysis suggesting that enrollment in the highest subsidy category exceeded the eligible population in nearly every Florida county, with some areas showing enrollment more than 11 times the estimated eligible population. Dr. Oz clarified that ACA enrollment fraud is not confined to Florida but represents a "nationwide problem" that CMS is actively working to address. The methodology behind the analysis cited by Dr. Oz was not detailed in the report.
CMS has identified several common issues contributing to these concerns, including applications submitted without Social Security numbers, unauthorized broker enrollments, and coverage obtained without explicit consumer requests. In response, the agency has implemented a multi-pronged approach that includes enrollment reviews, advanced data analysis, payment suspensions, and the revocation of provider credentials for those found to be engaged in fraudulent activities.
Separately, the Trump administration announced that nearly 1 million customers who paid premiums without assistance would receive $500 Obamacare refunds. These payments, distinct from the fraud enforcement efforts, are scheduled to commence in October and concern marketplace user fees. The administration continues to emphasize its commitment to combating fraud across the healthcare system, with President Trump and Vice President JD Vance's leadership guiding the White House Fraud Task Force. The task force is reportedly working across various agencies to strengthen oversight and accountability in federal health programs, signaling that these efforts are just beginning.
