In a statement today, CMS confirmed that Elon Musk and Government Efficiency Department (DOGE) have been reached to CMS payment systems:
The two senior CMs have two senior agency veterans – focusing on a policy and focusing on one operation – which leads cooperation with DOGE, including ensuring proper access to CMS systems and technology. We are taking a thoughtful approach to see where the more effective and efficient use of resources to meet the goals of President Trump.
Why is Dogi access? A potential goal is to identify fraud and abuse.
Yes, this is where big money is being cheated https://t.co/jxqxrlkdgp
– Elon Musk (@elonmusk) February 5, 2025
What is the possibility of finding? Andy Schnider of the University of Georgetown has a balanced evaluation of the current status of fraud, waste and misuse for CMS programs.
Medicade and Medicare and Private Health Insurance have waste and misuse, but they are very difficult to determine …
Some unfair payments are lost to fraud, ruin and misuse. But the medicade includes missing or insufficient documents to support the payment paid in most unfair payments. Medicade improper payment rate (5.09%in 2024) is not a fraud rate, waste rate or misuse rate.Garbage can take many forms in the federal-state program such as Medicade. An example is an unnecessary emergency chamber visit: beneficiaries seeking care in a hospital when they require health care, they can be provided at a very low cost in a doctor’s office or community clinic. Unnecessary ER travels are complicated due to lack of housing instability and access to effective primary care to other social determinants.
Additionally, it is not that the past has not evaluated fraud, waste and misuse. For example, both the Government Accountability Office (GAO), a hand of the Congress, and an executive branch agency, the office of the Inspector General (OIG), both have the responsibility of the oversight with the CMS and the State Medicade Agency Program Administration. Identifying waste and misuse in the program.
An approach to save money will refuse to pay any payment to providers, for this improper payment can be considered. This will save CMS money, but will change the cost of healthcare providers, which will not pay (i) if the document was incomplete or (ii) will need to increase their expenses on administrative staff so that it can be ensured that all can ensure that all The documents were fully processed.
In short, CMS is a commendable goal for taking Dogo to take fraud, waste and abuse. To do this in a efficient and effective manner, however, will be challenging.
