The Trump administration on Tuesday widened its efforts to stamp out Medicaid fraud, at least in its fifth state this year, calling on Florida officials to share information on how they identify, prevent, and address bad actors in their state program.
Centers for Medicare & Medicaid Services (CMS) Administrator Mehmet Oz, MD, MBA, had previously sent similar requests to New York, Minnesota, Maine, and California in what has been a growing, Trump administration-wide initiative to crack down on fraud, waste, and abuse.
The letter to Florida Gov. Ron DeSantis and other state leaders is the first such request that Oz has announced to a Republican-led state as the administration seeks to convey that fraud won’t be accepted regardless of political leadership.
It comes a day after President Donald Trump signed an executive order to create an anti-fraud task force across federal benefit…
MANAGEMENT & CULTURE (THE “TONE AT THE TOP”)
Fraud thrives in “sloppy” environments where leadership ignores the rules.
- The Fraud Triangle: For fraud to occur, three elements must be present: Pressure (the need for money), Rationalization (thinking “I deserve this”), and Opportunity (weak controls). You can only control the Opportunity.
- Whistleblower Hotline: Provide an anonymous way for staff to report “odd behavior.” Most internal frauds are caught via tips, not audits.
- Background Checks: Conduct credit and criminal record checks for all employees in financial or data-sensitive roles.
- Annual Ethics Training: Make sure every staff member knows that the company has a Zero Tolerance policy toward “borrowing” from petty cash or fudging overtime.