O&I Hearing: The Role of CMS in Combatting Medicare and Medicaid Fraud

The House Committee on Energy and Commerce's Subcommittee on Oversight and Investigations held a hearing on March 17, 2026, titled "Protecting Patients and Safeguarding Taxpayer Dollars: The Role of CMS in Combating Medicare and Medicaid Fraud." The hearing focused extensively on CMS's efforts to detect, prevent, and address fraud in Medicare and Medicaid programs, highlighting specific high-fraud areas such as durable medical equipment, hospice care, genetic testing, and home health services. Deputy Administrator Kimberly Brandt testified about CMS's data-driven approaches, including enhanced provider enrollment screening, predictive analytics, and collaboration with law enforcement, which have led to stopping billions in fraudulent payments. The hearing also covered CMS's actions to withhold Medicaid funding from states like Minnesota, California, New York, and Florida due to concerns over program integrity, sparking debate over the political motivations and impacts on vulnerable beneficiaries. Members discussed the balance between aggressive fraud prevention and ensuring access to care, with questions about CMS's processes, audits, and coordination with states. The hearing also touched on the administration's pardoning of convicted healthcare fraudsters and concerns about data privacy related to CMS datasets. Overall, the hearing underscored CMS's procurement and enforcement activities aimed at safeguarding federal healthcare funds and improving program integrity.