Corporations, Not Immigrants, Are Responsible for Vast Majority of Healthcare Fraud, OIG Report Shows

For more than a year, the Trump administration has sought to blame immigrants for widespread health care fraud. Immigrant communities, the Trump administration’s bunk theory goes, are draining resources and raising costs by defrauding the federal government.

The spurious allegations played a key role in Donald Trump’s massive — and deadly — immigration crackdown in Minnesota over the winter.

A semiannual report from the Department of Health and Human Services’ Office of Inspector General to Congress, however, highlights a different narrative.

The report, which covers enforcement actions over a six-month period, highlights the obvious: Corporations — not small immigrant-oriented healthcare providers, or undocumented immigrants illegally taking benefits — are responsible for the vast majority of alleged fraud in the American health care system.

Released earlier this month, the report highlights billions of dollars’ worth of healthcare fraud from corporate executives.

One CEO ran a scheme to target Medicare beneficiaries with medically unnecessary medical devices. An insurance broker and marketing executive orchestrated an Affordable Care Act enrollment scam that preyed on vulnerable people experiencing homelessness and substance abuse.

While C-suite fraudsters are the stars of the congressional report and most credible research on the topic, immigrants are at the cynosure of the administration’s public fraud campaign.

Freeing Actual Fraudsters

Experts on immigrant rights and healthcare say the administration is using immigrants as a scapegoat for systemic fraud in the healthcare system that can be attributed to corporate greed, while shielding actual bad actors who profit from a broken system.

“There isn’t really clear evidence of any systemic issues implicating immigrants,” said Sarah Krieger, senior policy counsel at the National Immigration Law Center. “The administration’s public messaging is focusing on immigrants and immigrant workers, but that’s constructing a narrative with the intent of hurting immigrants, not with actually rooting out any problems.”

Krieger pointed to examples of the Trump administration using clemency and pardons to get corporate healthcare fraudsters off the hook.

In May, President Donald Trump granted clemency to Lawrence Duran, the owner of a mental health company, American Therapeutic, who was sentenced to 50 years for “orchestrating a $205 million Medicare fraud scheme.”

An analysis by the California governor’s office found that Trump’s pardons had wiped nearly $2 billion in victim repayment and taxpayer recovery for Medicare and tax fraud, as well as other types of fraud.

Trump Focus on Immigrants

Though immigrants aren’t mentioned once in the report itself, they have been the relentless focus of the Trump administration.

In May, Vice President JD Vance and Mehmet Oz, a television doctor who is now head of the Centers for Medicaid and Medicare Services, hosted an anti-fraud press conference.

Related

Unnamed Source in Viral Minnesota Somali Fraud Video Is Right-Wing Lobbyist Who Called Muslims “Demons”

At the event, Vance erroneously warned that “there could be tens of billions of fraudulent payments in the California system” going toward “illegal aliens, going to fraudulent businesses.” Oz — best known for promoting diet pills — similarly claimed that hundreds of millions of dollars of “questionable expenditures” were linked to “immigration-related costs,” and that “folks who are undocumented” were fraudulently getting access to Medicaid funds in California.

The language is par for the course from administration officials. Later that month, deputy White House chief of staff Stephen Miller went so far as to blame the national debt on immigrants committing benefit fraud.

“We could balance the federal budget if the only dollars that went out of the Treasury went to individuals who were properly lawfully correctly eligible to receive them,” Miller said at a press conference.

The public rhetoric from Trump officials would lead one to false conclusions about who commits large-scale healthcare fraud — and who benefits.

“We are seeing a trend around the administration scapegoating immigrants and not pointing to the actual bad actors: corporations,” said Isha Weerasinghe, director of the public benefits justice team at the Center for Law and Social Policy, a Washington-based nonprofit that advocates for people with low incomes.

$300 Billion a Year

The National Health Care Anti-Fraud Association estimates that the cost of healthcare fraud could be as high as $300 billion a year.

Most of that fraud is from providers scamming patients and insurance by billing patients for services not rendered or performing medically unnecessary services for the purpose of generating insurance payments.

The administration does not want to highlight that type of fraud in their public rhetoric because they’re enabling it, said Krieger, of the National Immigration Law Center.

“The administration has cut funding for all sorts of internal enforcement mechanisms. They have provided clemency to people convicted of government fraud in the past. They’ve fired inspector generals for overseeing accountability,” she said. “They’re not actually interested in solving the problem.”

Data suggests that noncitizens are less likely to commit welfare fraud than citizens.

Weerasinghe said that the administration is using a well-worn tactic of blaming marginalized groups to take away benefits from the population more broadly. 

Related

Medicare Privatization Scheme Faced Legal Questions About Profiteering

“All of us know about the ‘welfare queen’ narrative, and that worked,” said Weerasinghe, referencing a racist trope popularized by Ronald Reagan to characterize Black people on benefits as greedy fraudsters. “It created a lot of hatred toward public benefits, and also this willingness for the public to be OK with this kind of crackdown that was absolutely unnecessary.”

Weerasinghe said the administration is using “the immigrant narrative in order to make their case to defer to defer funds.” Trump, for instance, recently froze more than $1 billion in Medicaid payments to California and Minnesota.

“They’re not interested in tackling any systemic issues that may exist,” said Krieger. “They’ve kind of constructed a problem in search of a solution, and the solution always is to blame immigrants.”

The post Corporations, Not Immigrants, Are Responsible for Vast Majority of Healthcare Fraud, OIG Report Shows appeared first on The Intercept.