SACRAMENTO, Calif. — For weeks, Mehmet Oz has been waging a public feud with California leaders over health care fraud, accusing the blue state of failing to adequately combat such abuse.
alleged that there was approximately $3.5 billion of fraud in the hospice and home health care industry in Los Angeles County alone. “This administration under President [Donald] Trump is not going to tolerate taxpayer dollars being stolen because people aren’t paying attention anymore. We’re focused on this,” Oz said. He claimed the fraud was largely orchestrated by the “Russian, Armenian mafia” and said that most of the money spent on home and community-based services across California “might be fraudulent.”
However, CMS clarified that not all billing activities referenced by Oz were presumed to be improper. And a review of the most recent available data shows that there are hotbeds of health…
Insurance fraud involves making false or exaggerated claims to an insurance provider.
- Hard Fraud: Someone deliberately causes a loss (e.g., setting fire to a warehouse or staging a car accident) specifically to collect a payout.
- Soft Fraud: More common and often viewed as “victimless” by the perpetrator. It involves exaggerating a legitimate claim, such as overstating the value of stolen items in a home burglary to cover the deductible.