You take the fraud out of Medicare, you double the life expectancy of the system. Think about that, you double it. That means it’ll be there for you, your kids, and so on and so forth. — Dr. Mehmet Oz
Dr. Mehmet Oz, Administrator of the Centers for Medicare and Medicaid Services, joined Dean Cain on The Homeland at the Great American State Fair in Washington, D.C., for a wide-ranging conversation on healthcare fraud, the MAHA movement, and the technological overhaul underway at CMS.
Speaking on the National Mall during the celebration of America’s 250th anniversary, Dr. Oz laid out the scale of the problem his agency faces: approximately $100 billion per year in fraudulent healthcare spending. He disclosed that in the past year alone, CMS prevented $42 billion in fraudulent payments from leaving its building, a figure he attributed to a renewed emphasis on program integrity and a whole-of-government enforcement strategy.
The Fraud Crisis: Scale and Consequences
Dr. Oz described a systemic breakdown that accelerated during the COVID era, when oversight was relaxed and guardrails were removed. He stated that this period taught a generation of criminals, including foreign multinational criminal organizations, that stealing from American healthcare programs carried little risk.
Among the most striking revelations: one million individuals were enrolled in the Affordable Care Act exchanges without Social Security numbers. Dr. Oz explained that without Social Security numbers, the government cannot verify income eligibility, and that investigations are revealing the majority of these enrollments are fraudulent, many tied to people who do not exist.
He noted that Obamacare enrollment has ballooned from a historical baseline of nine million to over twenty-three million, and that forty percent of current enrollees have never used their insurance once, further evidence that millions of enrollments are not legitimate.
Whole-of-Government Enforcement
Dr. Oz outlined a coordinated approach involving the Department of Justice, the Treasury Department, and the IRS. When CMS identifies fraud, DOJ pursues criminal prosecution. When stolen funds are laundered, Treasury tracks the money. When criminals fail to declare stolen income, the IRS is notified.
He confirmed that international enforcement operations are now underway, with the governments of the Philippines and Turkey cooperating to locate, detain, and extradite fraudsters who fled the United States with stolen funds. He cited recent joint announcements with DOJ leadership including Todd Blanche, Kash Patel, and Kyle McDonald.
Dr. Oz emphasized that the Vice President now leads the anti-fraud task force, a signal he described as both a directive to government agencies to end siloed operations and a warning to criminals that enforcement is unified and serious.
AI as a Fraud Detection Tool
CMS is deploying artificial intelligence to identify fraud patterns that human investigators miss. Dr. Oz drew a parallel to the financial sector, noting that bank managers historically fail at detecting fraud because they do not think like criminals, but AI systems can model fraudster behavior and identify suspicious tactics at scale. He said this technology is now helping CMS train investigators to anticipate and intercept fraud schemes before payments are made.
The Medicare Trust Fund
Dr. Oz connected the fraud conversation directly to the solvency of Medicare. He stated plainly that eliminating fraud from Medicare would double the life expectancy of the Medicare Trust Fund, ensuring the program remains available not only for current retirees but for their children and future generations.
MAHA and Preventative Health
The conversation shifted to the Make America Healthy Again movement and the administration’s focus on preventive care. Dr. Oz stated that 43 percent of Americans are obese, compared to 20 percent in Europe and 5 percent in Japan. He argued that the American healthcare system has historically made it difficult to be healthy, and that the MAHA movement aims to reverse this by emphasizing nutrition, reducing processed food in schools, and returning to whole-food diets.
He discussed the recent overhaul of the food pyramid and highlighted how previous dietary guidance led schools to replace whole-fat milk with skim milk supplemented by chocolate syrup, resulting in equivalent calories but inferior nutrition.
Nutrition in Medical Education
Dr. Oz announced that most medical schools in the country are now signing a pledge to incorporate culinary nutrition into their curricula. He argued that if physicians are not taught about nutrition, they assume it does not matter, and patients suffer as a result. He used the example of lycopene, explaining that the nutrient is best absorbed through cooked tomatoes mixed with fat (pasta sauce), not through supplements, and that physicians need to communicate this kind of practical knowledge to patients.
Technology Transformation at CMS
Dr. Oz revealed that CMS is undertaking a major technology transformation led by Amy Gleason. He stated that CMS systems were built in the 1970s, are not cloud-based, and cannot support modern patient-facing tools. The initiative involves every major American technology company and aims to give patients access to their own health data so they can seek second opinions, receive coaching, and connect with others managing similar conditions.
The Economic Case for Health
Dr. Oz closed with an economic argument: if the average American feels healthy enough to work just one additional year, the impact to GDP is approximately one trillion dollars annually. He framed this as the ultimate return on investment for preventive health policy, reducing national debt burden and tax pressure while extending the productive capacity of the workforce.
Watch this full episode and all episodes of The Homeland with Dean on Proud American Studios.
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