The dispute over New York’s Medicaid fraud probe began with figures that CMS used publicly while investigating what it described as potential issues in the state’s oversight. In comments last month, Dr. Mehmet Oz, the administrator of the Centers for Medicare & Medicaid Services, said New York’s Medicaid program provided personal care services to “some 5 million people” in 2025, a level he said was unusually high. CMS later told the Associated Press that the agency’s understanding of New York’s utilization was wrong and said it had refined the methodology used to calculate the numbers.
CMS spokesman Chris Krepich said the real number of New Yorkers who used personal care services last year was about 450,000, rather than close to three-fourths of New York’s roughly 6.8 million Medicaid enrollees. Krepich said CMS misidentified New York’s approach to applying billing codes and that the agency has since adjusted how it analyzes state-specific practices.
The corrected utilization figure was first raised by the administration to The Associated Press, according to the report, after Oz’s comments and a letter connected to the fraud probe. In a social media video, Oz argued that New York should “come clean about its Medicaid program,” and in the letter he characterized the state’s personal care utilization as excessive. Analysts questioned whether broader anti-fraud efforts being pursued by the administration relied on faulty findings in cases like New York.
Michael Kinnucan, a senior health policy adviser at the Fiscal Policy Institute, criticized the error in figures used to support the probe. Kinnucan said the numbers “could have been cleared up in a phone call” and described the episode as “slapdash,” after his analysis had highlighted the inaccurate claim. He said the mistake underscored concerns that the administration’s approach can become adversarial rather than collaborative.
CMS said the investigation was still ongoing even after acknowledging the corrected figure. In an emailed statement, Krepich said CMS remains committed to ensuring its analyses reflect state-specific billing practices and said the agency would work with New York to validate data and strengthen Medicaid program integrity oversight. Krepich also said the administration still had concerns about New York’s oversight of personal care services and Medicaid more broadly as it reviewed the state’s response to the letter.
The report said CMS had also flagged other issues with New York’s Medicaid program, including that it spends more per beneficiary and per resident than the average state, has high personal care spending, and employs so many personal care aides that the job category is now the largest in the state. New York health officials disputed the characterization, with Cadence Acquaviva, a senior public information officer for the New York Department of Health, saying the initial mischaracterizations were a “targeted attempt to obscure the facts.”
In response to the admission of error, a spokesperson for Gov. Kathy Hochul said New York’s officials were “glad they now admit it.” The spokesperson, Nicolette Simmonds, said in a statement that the initial claim by CMS was “patently false” and said Hochul has “zero tolerance” for waste, fraud and abuse in Medicaid and other state programs.
The New York probe fits into a wider federal crackdown on health-care fraud described by the report as extending beyond the state. The Trump administration has taken similar steps in at least four other states, including California, Florida, Maine and Minnesota, as part of anti-fraud efforts that officials said were aimed at waste in benefit programs. The report also said the administration’s broader actions include a Medicaid funding pause directed at Minnesota over fraud concerns.
In his video, Oz made other claims about New York that advocates said were inaccurate. The report said Oz claimed New York made eligibility “more lenient” for personal care by allowing problems like being “easily distracted” to qualify, but the Legal Aid Society’s Rebecca Antar said the opposite was true and that the state instead made the program requirements more stringent in a rule change that took effect last September. Krepich said Oz was referring to whether New York’s personal care standards were “sufficiently rigorous.”
Oz also described personal care services as something “our families would normally do for us,” such as carrying groceries. Kathleen Downes, a Nassau County resident who uses personal care services and described herself as quadriplegic with cerebral palsy, said she was offended by the suggestion that families can reliably provide unpaid help. Downes said she hires both her mother and outside assistants so her mother does not have to perform the tasks full time, and she said her mother’s unpaid labor limited her ability to pursue other work.