特朗普政府针对医疗保险欺诈,此前移植索赔激增 7100%
Trump Admin Targets Medicare Fraud After 7,100% Surge In Transplant Claims

原始链接: https://www.zerohedge.com/political/trump-admin-targets-medicare-fraud-after-7100-surge-transplant-claims

特朗普政府已对医疗保险(Medicare)欺诈展开了大规模打击行动,重点针对组织和器官移植(同种异体移植)索赔中惊人的 7,100% 激增现象——该项索赔金额从 2019 年的 2 亿美元飙升至 2025 年的 144 亿美元。 在白宫反欺诈工作组和医疗保险与医疗补助服务中心(CMS)局长梅赫梅特·奥兹(Mehmet Oz)博士的领导下,政府已拦截了数亿美元的可疑付款。自 3 月以来,当局已驳回了 96% 的经审查同种异体移植索赔,查明了 2.24 亿美元的潜在欺诈金额。 此外,工作组还积极针对耐用医疗设备(DME)欺诈进行打击,包括涉及不必要或未交付设备的计划。政府已撤销了 725 家供应商的计费资格,并暂停了另外 102 家供应商的付款,从而有效遏制了 DME 欺诈行为。 奥兹博士强调,这种“全政府”式的方法对于保护医疗保险系统免于财政崩溃至关重要,并警告不法分子,政府将继续进行追查。副总统万斯的一位发言人表示,这些迅速的执法行动已经有效地终结了这波欺诈浪潮,兑现了追究腐败实体责任的承诺。

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原文

Via American Greatness,

The Trump administration says it has uncovered a dramatic increase in Medicare claims for tissue and organ transplants, resulting in a broad crackdown on suspected fraud that officials say has already blocked hundreds of millions of dollars in questionable payments.

Administration officials said Medicare claims for tissue and organ transplants, known as allografts, climbed from $200 million in 2019 to $14.4 billion in 2025—a 7,100 percent increase.

The surge led the White House Anti-Fraud Task Force, headed by Vice President JD Vance, and the Centers for Medicare and Medicaid Services to intensify their review of claims. Since March, the agency has denied 96 percent of allograft claims identified during the review.

CMS Administrator Mehmet Oz said the agency identified 4,200 potentially fraudulent allograft claims totaling $224 million through May.

“That’s a lot of money,” Oz said during a Wednesday news conference in Milwaukee.

“And that bankrupts not just hospital systems and physician groups, but it causes major problems across the entire landscape.”

The agency also announced enforcement actions involving Durable Medical Equipment (DME) including wheelchairs, walkers, hospital beds and other medical equipment.

According to CMS, payments have been suspended to 102 suppliers, while billing privileges have been revoked for another 725 suppliers. The agency said those suppliers accounted for 8.6 percent of all Medicare-funded DME in 2025.

CMS officials reported they identified suspected fraud involving claims for equipment that was not medically necessary or ordered, equipment that was more expensive than prescribed, and equipment that was never delivered.

“In just six months, the task force has effectively wiped out Durable Medical Equipment fraud in America,” a spokesperson for Vance’s office said.

“After the vice president and Dr. Oz announced a moratorium on new DME companies, paired with aggressive enforcement actions by DOJ and HHS, this kind of fraud has effectively ended.”

Oz said the administration’s efforts have already prevented significant losses.

“Thanks to the whole-of-government approach spearheaded by the White House Anti-Fraud Task Force, we stopped nearly $220 million in fraudulent skin substitute claims and suspended or revoked billing privileges for over 800 DME suppliers,” Oz told Fox News Digital. “We are keeping our promise to the American people: we will root out corruption, protect vulnerable patients, and hold every bad actor accountable.”

Oz also warned those engaged in health care fraud that the administration intends to continue its enforcement campaign.

“To anyone out there, and I’m talking to you if you’re a fraudster, for anyone out there who thinks they can get away by stealing from the American people, especially American patients, I’ve got a bit of advice for you: Do not walk away from this press conference. Don’t walk away from us. You start running because the vice president and this task force are coming after you,” Oz said.

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