Trump CMS Admits Major Error in New York Medicaid Personal Care Fraud Accusation Used to Justify Federal Probe
The Trump administration’s Centers for Medicare & Medicaid Services has acknowledged a “significant error” in data used to justify a federal fraud probe of New York’s Medicaid program after falsely claiming roughly 5 million people received personal care services last year when the actual figure is about 450,000 — an error CMS says stemmed from misidentifying New York’s use of a billing code and that it has since refined its methodology. New York officials and outside experts called the original claim patently false or “slapdash,” saying the mistake could have been resolved easily, while CMS says the probe remains ongoing and continues to flag New York’s higher per‑beneficiary spending and large personal‑care workforce.
📌 Key Facts
- CMS Administrator Mehmet Oz claimed New York’s Medicaid program delivered personal care services to roughly 5 million people in the last year; the actual figure is about 450,000.
- The Trump administration and CMS acknowledged to the Associated Press that they made a 'significant error' in the data used to help justify a federal fraud probe into New York’s Medicaid program.
- CMS said the error stemmed from misidentifying New York’s approach to applying billing codes for personal care services and has 'refined its methodology.'
- Despite the admitted data error, CMS says the federal probe of New York’s Medicaid program is ongoing and the agency is reviewing the state’s response to last month’s letter.
- CMS continues to cite New York’s higher per‑beneficiary and per‑resident Medicaid spending, high personal‑care spending, and the large personal‑care aide workforce as remaining 'flags,' while health analysts say those differences reflect higher costs and a policy choice to fund robust at‑home care.
- Outside experts, including Fiscal Policy Institute adviser Michael Kinnucan, criticized the agency’s work as 'slapdash' and said the incorrect numbers 'could have been cleared up in a phone call.'
- New York officials — Gov. Kathy Hochul and Department of Health spokesperson Cadence Acquaviva — called CMS’s initial claims 'patently false' and 'a targeted attempt to obscure the facts,' and said the state remains committed to protecting Medicaid services.
📊 Relevant Data
In 2023, the distribution of Medicaid enrollees in New York by race/ethnicity was approximately 27% White, 19% Black, 34% Hispanic, 12% Asian/Pacific Islander, and 8% other or unknown.
New York's Medicaid enrollment grew due to expansions under the Affordable Care Act, with childless adults between 100% and 138% of the federal poverty level becoming eligible, contributing to higher enrollment rates compared to states without such expansions.
New York Medicaid Enrollment by Eligibility Category — United Hospital Fund
The national Medicaid improper payment rate was estimated at 5.5% in fiscal year 2024, with variations by state but no systematic evidence of higher rates in Democratic-led states compared to Republican-led ones.
In New York, poverty rates contribute to high Medicaid enrollment, with 14.3% of the population below the poverty line in 2023, higher among Black (18.5%) and Hispanic (20.1%) residents compared to White (10.2%).
New York State Health Indicators by Race and Ethnicity, 2021-2023 — New York State Department of Health
New York's home care utilization in Medicaid grew at an average rate of 3.9% per year since 2018, with actual personal care service recipients around 450,000 in 2024, far below the erroneous 5 million claim.
How Fast is New York's Home Care Program Growing? — Fiscal Policy Institute
📊 Analysis & Commentary (1)
"A Wall Street Journal editorial defends Medicare Advantage and the Trump administration’s CMS plans (including possible auto‑enrollment), rebutting Democratic claims that the program wastes money and arguing private plans can curb fraud and protect Medicare finances."
📰 Source Timeline (3)
Follow how coverage of this story developed over time
- CMS spokesman Chris Krepich told AP the mistake stemmed from misidentifying New York’s approach to applying billing codes for personal care services and said CMS has 'refined its methodology.'
- Krepich stated the probe of New York’s Medicaid program is still ongoing and CMS is reviewing the state’s response to last month’s letter, despite the data error.
- The article quotes Fiscal Policy Institute adviser Michael Kinnucan calling the administration’s work 'slapdash' and saying the wrong numbers 'could have been cleared up in a phone call.'
- New York Department of Health spokesperson Cadence Acquaviva labeled Oz’s original claims 'a targeted attempt to obscure the facts' and said the state remains committed to protecting Medicaid services.
- The article details that CMS continues to cite New York’s higher per‑beneficiary and per‑resident Medicaid spending, high personal‑care spending, and the large size of the personal‑care aide workforce as ongoing 'flags,' while health analysts say those reflect both New York’s higher costs and a policy choice to fund robust at‑home care.
- CMS Administrator Mehmet Oz falsely claimed New York’s Medicaid program delivered personal care services to roughly 5 million people in the last year; the actual figure is about 450,000.
- The Trump administration has acknowledged to the Associated Press that it made a 'significant error' in the data it used to help justify a federal fraud probe into New York’s Medicaid program.
- The error stemmed from CMS misidentifying New York’s use of a billing code, and outside health policy experts say the mistake could have been corrected with a simple phone call.
- New York Gov. Kathy Hochul’s office publicly called CMS’s initial claim 'patently false' and welcomed the agency’s admission of error.