特朗普政府阻止逾16亿美元不当医保实验室支付，机构称

Trump admin blocks more than $1.6B in potentially improper Medicare lab payments, agency says

August 28, 2026 11:16am EDT / Fox News

CMS says 157 lab providers removed from Medicare for allegedly billing for tests never performed or not medically necessary

By Stephen Sorace, Preston Mizell, Fox News

We’ve uncovered so many ‘wasps nests’ of fraud in the system: Dr. Oz

Dr. Mehmet Oz vows to eliminate multi-billion dollar billing scams and systemic waste within the healthcare system.

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Federal officials have blocked or clawed back more than $1.6 billion in potentially improper Medicare laboratory payments since President Donald Trump returned to office, including $732 million tied to 157 lab providers booted from the program for alleged fraud.

The Centers for Medicare and Medicaid Services (CMS) said the labs were suspected of billing Medicare for tests that were never performed, tests patients did not need and services billed at higher rates than they should have been.

“When laboratories bill Medicare for tests they never performed, it drains the Medicare Trust Fund and diverts resources away from beneficiaries who need them,” CMS Administrator Dr. Mehmet Oz said.

DOJ CHARGES 19 DEFENDANTS IN ALLEGED $4M PHILADELPHIA MEDICARE AND MEDICAID FRAUD

President Donald Trump speaks as Administrator for the Centers for Medicare & Medicaid Services Mehmet Oz looks on during an event on drug pricing in the South Court Auditorium on the White House campus on Feb. 5, 2026, in Washington, D.C.(Nathan Howard/Getty Images)

In one case, the owner of a consulting company enrolled 14 labs in Medicare and billed the program more than $24 million, even though CMS said none of the labs appeared to be operating.

CMS has since held back $12 million in payments to the labs and recovered another $7 million. Eleven of the 14 labs have been removed from Medicare, while the remaining three are still under investigation.

CMS said it is using artificial intelligence and other technology to sift through Medicare claims and spot unusual billing that could be a sign of fraud.

The technology looks for billing that falls outside normal patterns and can flag suspicious claims for closer scrutiny. CMS can then hold, reject or deny a claim before Medicare pays it.

Vice President JD Vance speaks next to Administrator for the Centers for Medicare and Medicaid Services Mehmet Oz about combating fraud at the Eisenhower Executive Office Building in Washington, D.C., Feb. 25, 2026.(REUTERS)

Of the $1.6 billion cited by the agency, more than $500 million in suspected fraudulent payments were stopped through 185 payment suspensions after CMS investigated 600 labs.

“The previous administration treated our taxpayer-funded programs as piggy banks for fraudsters,” the White House told Fox News Digital. “That is no longer the case, thanks to President Donald Trump, Vice President JD Vance, and Dr. Oz, who is an anti-fraud superstar.”

TREASURY HAILS SUCCESS OF ANTI-FRAUD PROCESS THAT FLAGGED AND PREVENTED $99 MILLION IN PAYMENTS TO DEAD PEOPLE

The agency also recovered more than $276 million in overpayments made to 442 suspect labs and said another $127 million in potentially fraudulent payments was prevented after 85 cases were referred to law enforcement.

CMS pointed to two recent cases in Texas as examples of labs suspected of billing Medicare for services they did not provide.

One lab began billing Medicare in late February. CMS said it caught the suspicious activity early and denied $1.2 million in claims.

The lab then changed the way it billed Medicare in early April in an apparent attempt to get around the agency’s safeguards, according to CMS. Officials continued watching its claims and stopped more than $150,000 in additional payments before removing the provider from Medicare later that month.

Vice President JD Vance looks on as Medicare and Medicaid Administrator Mehmet Oz speaks about combating fraud at the White House complex in Washington, D.C., on Feb. 25, 2026.(Oliver Contreras/AFP via Getty Images)

DR OZ SAYS 800 HOSPICE PROVIDERS SUSPENDED IN CALIFORNIA OVER ALLEGED $1B MEDICARE FRAUD SCHEME

Another Texas lab began billing heavily in May after submitting test claims two days earlier in the year. CMS denied $1.9 million in claims and captured another $1.7 million in payments. The lab remains under review and could be removed from Medicare.

The lab cases are part of a wider Trump administration push to combat improper Medicare billing involving medical equipment, hospice care, skin treatments and other services.

CMS said its Medicare fraud prevention efforts saved $42 billion in fiscal year 2025. So far in 2026, the agency says it has identified $1.8 billion in Medicare overpayments and recovered $378 million in overpayments from post-payment reviews.

Since Jan. 1, CMS has also frozen more than $371 million in Medicare payments involving 267 providers and suppliers. That includes more than $226 million in suspected improper billing for medical equipment, more than $53 million involving skin treatments and more than $23 million involving hospice providers.

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“We won’t stop until we’ve restored program integrity and ensured that fraudsters have nowhere left to hide,” Oz said.