2026-10-08T14:37:00-04:00 / 福克斯新闻
调查人员发现部分服务机构单日 billed 时长超过24小时后，超过220家服务机构被终止合作
文/查尔斯·克莱茨 福克斯新闻
发布于2026年10月8日 美国东部时间下午2:37
小罗伯特·F·肯尼迪因欺诈担忧冻结加州、明尼苏达州10亿美元医疗补助资金
小罗伯特·F·肯尼迪因涉嫌欺诈，冻结了加州和明尼苏达州的10亿美元医疗补助资金。加州州长加文·纽瑟姆强烈驳斥这些指控，称其“纯属政治操弄”并指责特朗普政府。明尼苏达州州长蒂姆·瓦尔茨的支持率在欺诈调查后暴跌31个百分点，凸显了忽视此类问题的严重政治风险。
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据佛罗里达州官员透露，在调查人员发现可疑计费行为后，该州全面的医疗补助欺诈打击行动已推动仅行为治疗服务一项的预计年度支出减少近10亿美元。
塔拉哈西的内部打击行动——包括发现有服务机构向医疗补助机构申报的服务时长超过一天总时长——正值联邦政府对医疗补助欺诈的审查升级之际，其中包括涉及明尼苏达州的调查和付款审核。
德桑蒂斯政府表示，其举措旨在在纳税人资金拨付前阻止可疑的医疗补助索赔，而非事后追回不当付款。这一策略呼应了美国卫生与公众服务部部长小罗伯特·F·肯尼迪对摒弃传统“先付款后追讨”模式的呼吁。
“今年，我们宣布了该州历史上规模最大的医疗补助诚信行动，今天我很自豪地宣布这些努力取得的部分成果，”州长罗恩·德桑蒂斯在一份新闻稿中表示。
万斯就医疗补助欺诈打击行动以联邦资金威胁向各州施压
过去一年里，已有超过220家医疗补助服务机构因欺诈、浪费或滥用职权被终止合作，另有260多家机构面临付款限制或暂停服务。该州还向总检察长办公室提交了150多起涉嫌欺诈案件。
据州长办公室数据，原本预计2026至2027财年佛罗里达州用于应用行为分析（ABA）——一种常用于自闭症儿童的治疗手段——的医疗补助年度支出将达到38.6亿美元，现在预计总额为28.8亿美元。官员们将近9.8亿美元的支出削减归因于欺诈执法、管理式医疗和使用管理等多项措施的共同作用。
佛罗里达州医疗保健管理局（AHCA）向福克斯新闻数字频道透露，其扩大的监测范围发现，部分服务机构连续数月在每个周末和节假日都向医疗补助机构申报服务，其中包括单日申报服务时长超过24小时的案例。
“保护医疗补助就是保护其设立初衷服务的人群，”医疗保健管理局局长谢瓦恩·哈里斯在一份声明中表示。
欺诈专家揭露隐藏网络如何推动明尼苏达州欺诈及其他重大骗局：“犯罪团伙”
“对于儿童、孕妇、残障人士和老年人而言，这意味着确保他们能够获得高质量的护理，同时确保纳税人的资金不会因欺诈或滥用而流失。医疗保健管理局将继续采取果断行动，加强项目诚信，追究不良行为者的责任，并为佛罗里达州民众守护这些关键服务，”她说道。
哈里斯所在的机构向福克斯新闻数字频道提供了其打击行动的更多细节，包括其新型欺诈保护机制的运作方式。
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通过与身份验证公司SentiLink开展的试点项目，佛罗里达州正在筛查医疗补助服务机构的被盗或伪造身份以及隐藏的所有权结构。此外，该州已对某些高风险服务类别实施了注册暂停令。
医疗保健管理局还向福克斯新闻数字频道透露，自2026年1月以来，该局已就医疗补助服务机构的注册或重新注册作出了1000多份不利决定，这是其防止可疑机构进入或继续留在该计划中的努力的一部分。
自1月以来，该机构已对服务机构开展了400次现场访问，其中包括应用行为分析、医疗设备和成人日托等高风险类别机构。
“医疗补助欺诈是一个全国性问题，且在各地都变得更加复杂精密，”医疗保健管理局向福克斯新闻数字频道表示。
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视频：医疗补助欺诈指控波及关键自闭症服务
“佛罗里达州不会坐等指示。我们正在打造这套模式：在入口处防范欺诈、验证每一家服务机构并追踪数据。我们欢迎与医疗保险和医疗补助服务中心（CMS）及其他州开展合作，因为在佛罗里达州被阻止的欺诈性服务机构，意味着不会有骗局流窜到下一个州。”
本文作者在宾夕法尼亚州阿伦敦出生长大，自2013年起在福克斯新闻纽约和华盛顿分社工作。
https://www.foxnews.com/video/6401961421112
https://www.foxnews.com/video/6405237270112
DeSantis fraud crackdown drives nearly $1B spending plunge after providers billed impossible hours
2026-10-08T14:37:00-04:00 / Fox News
More than 220 providers were terminated after investigators found billing for more than 24 hours of services in a single day
By Charles Creitz Fox News
Published October 8, 2026 2:37pm EDT
RFK Jr. freezes $1 billion in Medicaid to California, Minnesota over fraud concerns
Robert F. Kennedy Jr. puts a $1 billion Medicaid freeze on California and Minnesota over suspected fraud. California Governor Gavin Newsom vehemently rejects these allegations, calling them ‘pure politics’ and blaming the Trump administration. Minnesota Governor Tim Walz’s approval plummeted 31 points after a fraud investigation, indicating the severe political risks for ignoring such issues.
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Florida’s sweeping Medicaid fraud crackdown has helped drive a nearly $1 billion reduction in projected annual spending on behavioral therapy services alone, according to state officials, after investigators uncovered suspicious billing practices.
Tallahassee’s internal crackdown — which included discoveries of providers billing Medicaid for more hours than there are in a day — comes amid heightened federal scrutiny of Medicaid fraud, including investigations and payment reviews involving Minnesota.
The DeSantis administration said its approach aims to stop suspicious Medicaid claims before taxpayer dollars are paid out rather than trying to recover improper payments afterward. The strategy mirrors a call from HHS Secretary Robert F. Kennedy Jr. to move away from traditional “pay-and-chase” models.
“This year, we announced the most significant Medicaid integrity initiative in the history of our state, and today, I was proud to announce some of the results from these efforts,” Gov. Ron DeSantis said in a news release.
VANCE TURNS UP HEAT ON STATES WITH FEDERAL CASH THREAT OVER MEDICAID FRAUD CRACKDOWN
Florida Gov. Ron DeSantis speaks during a press conference on April 10, 2025, in Miami, Florida.(Joe Raedle/Getty Images)
More than 220 Medicaid providers have been terminated for fraud, waste or abuse, while more than 260 have faced payment restrictions or suspensions. The state has also referred more than 150 suspected fraud cases to the attorney general’s office over the past year.
Annual Medicaid spending on Applied Behavior Analysis (ABA), a therapy commonly used for children with autism, had been projected to reach $3.86 billion but is now expected to total $2.88 billion in fiscal year 2026-27, according to the governor’s office. Officials attributed the nearly $980 million reduction to a combination of fraud enforcement, managed care and utilization management efforts.
Florida’s Agency for Health Care Administration (AHCA) told Fox News Digital that its expanded monitoring uncovered providers billing Medicaid for services through every weekend and holiday for months, including instances in which providers billed for more than 24 hours of services in a single day.
“Protecting Medicaid means protecting the people it was created to serve,” AHCA Secretary Shevaun Harris said in a statement.
FRAUD EXPERT EXPOSES HOW HIDDEN NETWORKS DROVE MINNESOTA FRAUD, OTHER MAJOR SCAMS: ‘CRIMINAL ENTERPRISE’
Agency for Health Care Administration Secretary Shevaun Harris speaks during a news conference held at the Health Care District of Palm Beach County on Tuesday, Oct. 6, 2026, held to announce a state-wide crackdown on Medicaid fraud.(Amy Beth Bennett/Getty Images)
“For children, pregnant women, the disabled, and our seniors, it means making sure they have access to high-quality care while ensuring taxpayer dollars are not lost to fraud or abuse. AHCA will continue taking decisive action to strengthen program integrity, hold bad actors accountable and safeguard these critical services for Floridians,” she said.
Harris’ agency provided additional details on its crackdown to Fox News Digital, including how its new fraud-protection mechanisms work.
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Through a pilot program with identity-verification firm SentiLink, Florida is screening for stolen or fake identities and hidden ownership structures among Medicaid providers. Separately, the state has imposed enrollment moratoriums on certain high-risk provider categories.
AHCA also told Fox News Digital that it has issued more than 1,000 adverse decisions involving Medicaid provider enrollment or re-enrollment since January 2026, part of its effort to prevent suspicious providers from entering or remaining in the program.
The agency has conducted 400 site visits to providers since January, including providers in high-risk categories such as applied behavior analysis, medical equipment and adult day care.
“Medicaid fraud is a national problem, and it is growing more sophisticated everywhere,” AHCA told Fox News Digital.
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Video: Medicaid fraud allegations target critical autism services
“Florida is not waiting to be told what to do. We are building the model: prevent fraud at the front door, verify every provider, and follow the data. We welcome partnership with CMS and other states, because a fraudulent provider stopped in Florida is a scheme that does not move on to the next state.”
Born and raised in Allentown, Pennsylvania, worked in both the New York and Washington bureaus for Fox News since 2013.
https://www.foxnews.com/video/6401961421112
https://www.foxnews.com/video/6405237270112
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