This was an incredible segment.
Before ending his interview with CNBC Squawk Box this morning, CMS Administrator Dr. Oz took a moment to sound the alarm on America’s $100 BILLION healthcare fraud epidemic.
And then he dropped a line that really says it all:
“They’re not just stealing your money, they’re stealing your health.”
Every CNBC viewer heard it loud and clear.
Dr. Oz was responding to CNBC’s Becky Quick, who asked him what his biggest goal was for the year.
He went straight after one of the biggest problems facing Medicare and Medicaid.
DR. OZ: “Can I touch on one last thing before I leave you?”
QUICK: “Yeah, I was going to ask what your biggest goal is for this year?”
DR. OZ: “We have got to deal with the fraud issues, and here’s why.”
“They’re not just stealing your money, they’re stealing your health, because if they don’t care about stealing from poor people, they’ll take your health away, and they’re stealing the nation’s trust.”
“Medicare and Medicaid were created in a high trust environment.”
“We assumed people would do the right things. We now are experiencing about $100 billion of theft a year, much of it because of the Covid pandemic impact on teaching criminals to move into healthcare.”
“And we believe if we could just take the fraud out of Medicare, we would double the life expectancy of the Medicare trust fund, which means not only would you have it for your retirement, but it could be there for your kids as well.”
Every angle of the way in which Oz outlined the problem was raw and gritty, but it needed to be said.
What Oz revealed next was truly staggering. He said the administration has stopped more than $42 BILLION in fraudulent payments from going out the door.
The money never even left the government coffers.
DR. OZ: “We already stopped $42 billion, Kim Brandt, who leads this program at Medicare, has already taken $42 billion just by not shipping the money out of the building.”
“So number one issue is don’t let the criminals get the money from you.”
“Number two, an all of government approach to get it back.”
“We’re working closely with Scott Bessent, a big announcement that he’ll make this week about how effective that has been.”
Quick then pressed him on who exactly was behind the fraud.
His answer went a lot deeper than just individual doctors submitting a few questionable claims. This was an interconnected network that went all the way to the Cuban government and the Chinese mafia.
DR. OZ: “All of it. We’ve got foreign governments involved, we believe.”
“South Florida, where we had a moratorium on durable medical equipment suppliers, we think the Cuban government might have been involved.”
“Here in New York City…you go to Queens, there’s a massive fraud scheme with social adult day care, where they’re basically paying seniors to play mahjong.”
“And literally, and you’ve got the Chinese mafia actively involved in that. They’re also running human trafficking because once they get a cash cow, like selling, you know, memberships, club memberships to seniors where they basically get their Medicare beneficiary number, which millions have been stolen now, and just charge the government as though they’re legitimate bills.”
“So this has to be shut down. And it is we’re going after it in a big way.”
This is an all-out war on fraud.
That’s when Dr. Oz revealed that CMS is using artificial intelligence as a weapon in its arsenal to hunt down criminals and root out fraud within America’s healthcare system.
CNBC’s Andrew Ross Sorkin asked Dr. Oz how the government is using AI.
His answer was wild. It sounded like something out of a crime thriller.
DR. OZ: “We are very, very actively involved with all the frontier models, and we use those models very effectively.”
“You know, why it works?”
“We don’t think like fraudsters…actually, I talked to Moynihan about this. You mentioned him earlier, from Bank of America.”
“What I didn’t realize was bank managers aren’t good fraudsters. They don’t think that way. But fraudsters are really good at it.”
“So if you use AI to get a bank manager to think like a fraudster and do the things they would have done to prevent what they’re about to do, it actually works.”
“We’re now taking a page from that playbook and using it in government.”
AI is now allowing government agencies to think like “Chinese criminals” and the “Russian mafia” who are scamming America’s healthcare system.
“So we’re thinking the way a Chinese criminal’s thinking about fraud in New York City or Russian mafia in Los Angeles.”
“By the way, we shut down half the hospices in Los Angeles…and they didn’t complain!”
“If I shut down a business that you own making tens of millions of dollars a year, would you make noise about it?”
“If you’re legitimate…nothing. ZIP!”
CMS is trying to predict how fraudsters operate before they can drain more taxpayer money...and the administration is using AI to help expose the networks behind the schemes.
This is exactly what PayPal did in the early days to completely wipe out the fraud problem that was destroying the company.
It worked for them.
The final example Oz gave may have been one of the craziest healthcare fraud stories ever told on CNBC.
Dr. Oz was explaining how deeply fraud has become embedded in the healthcare system when he recalled a bust in Philadelphia.
The suspect was being arrested for drug possession and sales, but before the police could cuff him, he had to log out of his day job…
DR. OZ: “Some of the things these charlatans do is, they’re shockingly effective at being grifters…”
“I was just doing a bust in Philadelphia and a guy was getting arrested and they’re about to cuff him, and he said, before you cuff me, I got to log out of my day job, which is being a home care attendant.”
“And the cop said, what are you talking about? I’m arresting you for narcotics possession and sales.”
“And he says, yeah, I got that as a side gig. But my real money is like all the drug dealers became home care providers and he logged out on his phone.”
Oz said the suspect responded to the arresting officers with a line that perfectly encapsulated just how bad the problem is.
“He said, if you arrest me, you have to arrest everybody in Philadelphia…”
This was a devastating conclusion.
“We have normalized criminal behavior.”
“We have normalized fraud.”
“We have normalized stealing from the poor.”
“That is an abdication of trust, we cannot tolerate as a nation.”
“That’s why we’ve been so aggressive on this. We’re making huge inroads, and I’m quite confident that over the next year, we’ll send a very clear message: if you want to steal, don’t do it from the federal taxpayer.”
The government is no longer willing to sit idly by and watch the thieves loot the American system without putting up a fight.
Clean, clear, concise and exciting reporting. A joy to read 🤩
Give them hell Doc! 🇱🇷