Dr. Mehmet Oz has uncovered a massive financial drain on taxpayers through Medicaid enrollment fraud. The Centers for Medicare & Medicaid Services administrator identified billions of dollars being wasted while Americans who truly need the program struggle to receive care.

According to Fox News, Oz revealed approximately $14 billion in fraudulent spending through a practice called dual enrollment, where individuals are incorrectly registered for Medicaid benefits in multiple states simultaneously.

"There's about $14 billion we've identified with DOGE, of folks who are duly enrolled wrongly in multiple states for Medicaid," Oz explained during an appearance on "Sunday Morning Futures." He cited an example where someone might move from New Jersey to Pennsylvania but end up receiving benefits from both states, with each collecting federal funds for the same individual.

Medicaid system needs cleaning

The prominent physician-turned-administrator emphasized that Medicaid requires significant reform to fulfill its original purpose. The program was designed to assist vulnerable populations, including those at the beginning or end of life, individuals "living in the shadows," and people with disabilities.

These intended beneficiaries often struggle to access care because resources are being diverted to ineligible recipients who are "clawing at the cloth" of the system. This misallocation prevents the program from functioning as designed and creates barriers for those who legitimately qualify for assistance.

Republicans have been vocal about the need to eliminate waste, fraud, and abuse in federal medical assistance programs. However, these efforts have faced pushback from critics who worry that reform legislation might threaten healthcare coverage for vulnerable populations who depend on these services.

State incentives create problems

Oz highlighted a concerning structural issue within the Medicaid system that incentivizes states to maintain inflated enrollment numbers. Under the program's expansion, the federal government covers up to 90% of costs in some states compared to just 50% or 60% in others.

This uneven funding structure encourages states to keep more able-bodied adults enrolled in Medicaid even when they might not qualify, as it brings in more federal dollars. The financial incentive has created a situation where states are reluctant to cooperate with federal efforts to verify eligibility and remove ineligible participants.

Oz also pointed out a troubling payment disparity, noting that "in many states, if you go to the hospital, and you're an able-bodied person, the hospital gets paid more [for a Medicaid beneficiary] than if you're a Medicare beneficiary." This creates a perverse system where those who have contributed to Medicare throughout their working lives receive less value than able-bodied individuals on Medicaid.

Work requirements missing

The lack of federal work requirements for Medicaid recipients represents another significant concern, according to Oz. He contrasted this with other federal assistance programs like SNAP (Supplemental Nutrition Assistance Program), commonly known as food stamps, which do maintain work requirements.

Oz clarified that such requirements don't necessarily mean holding a job but rather making efforts to secure employment. "It doesn't mean you have a job. It means you're trying to get a job – which is a good thing because we have twice as many jobs as there are people looking for them right now," he explained during the interview.

For those unable to work traditional jobs, Oz suggested alternatives like volunteering, pursuing education, or helping with household responsibilities. He argued that implementing such requirements would address the "moral hazard" created when able-bodied individuals who could and should work remain unemployed.

Taxpayer burden grows

The $14 billion in identified fraud represents a significant burden on American taxpayers at a time when fiscal responsibility has become a major political focus. House Speaker Mike Johnson has previously addressed concerns about healthcare program reforms, emphasizing that safeguarding Medicare, Medicaid, and Social Security remains a "big priority" for Republicans.

Johnson has distinguished between protecting these programs and allowing continued waste, specifically noting the need to remove "able-bodied workers... young men who should never be on the program at all." This aligns with Oz's assessment that ineligible participants are straining the system.

The current system's structure has created a situation where taxpayers are effectively subsidizing individuals who could be contributing to the workforce instead of receiving benefits. This financial burden comes as many eligible patients struggle to navigate a healthcare system that doesn't prioritize their needs as intended.