Representatives of Elon Musk’s Department of Government Efficiency (DOGE) - who just obtained security clearances, have been embedded at the Centers for Medicare and Medicaid Services (CMS) this week, gaining access to critical payment and contracting systems, according to the Wall Street Journal, citing multiple individuals familiar with the situation.

The DOGE representatives have been on site at the agency’s offices this week, the people said, and they are looking at the systems’ technology as well as the spending that flows through them, with a focus on pinpointing what they consider fraud or waste. DOGE representatives are also examining the agency’s organizational design and how it is staffed, the people added.

Musk confirmed his interest in CMS oversight in a social media post, writing on X: "Yeah, this is where the big money fraud is happening."

The White House and DOGE officials declined to comment on the matter. In the last week, Musk’s DOGE team has been moving swiftly to gain access across multiple federal agencies, including the Treasury Department and the U.S. Agency for International Development (USAID) to uncover fraud, abuse, and excessive spending.

A CMS official told the Journal that the agency has assigned “two senior agency veterans who are leading the coordination with DOGE," and that leaders are "taking a thoughtful approach to see where there may be opportunities for more effective and efficient spending in line with meeting the goals of President Trump."

CMS sits at the heart of the nation’s healthcare economy, managing a budget of approximately $1.5 trillion in fiscal 2024 - roughly 22 percent of total federal spending. The agency employs around 6,710 people and administers Medicare, Medicaid, and other healthcare programs vital to millions of Americans. Many of its employees have spent decades navigating the complex regulatory and operational framework underpinning the healthcare system.

Among the systems DOGE representatives have accessed is CALM, the CMS Acquisition Lifecycle Management system, which contains contract data, sources said. However, they noted that DOGE personnel have not yet gained entry to databases containing personally identifiable health information of Medicare and Medicaid beneficiaries. They also have not accessed HIGLAS, the Healthcare Integrated General Ledger Accounting System, a key accounting platform for CMS payments.

One person familiar with DOGE’s work at CMS emphasized that the current level of access is "read-only," preventing Musk’s team from making modifications to the systems.

The intervention has raised concerns among CMS veterans and healthcare policy experts. The agency’s payment structures are notoriously complex, involving multiple layers of contractors and private insurers, especially within Medicare. Medicaid, jointly administered by federal and state governments, follows different financial pathways, with federal funding typically flowing to state agencies.